Track Newborn Charges and Delay Billing the Family

Your practice can add a newborn patient to your PCC system, track newborn hospital and office encounters, and delay billing until the family has updated their insurance information. Read below to learn more.

Contents

1 What is Your Practice’s Grace Period?
2 Add the Patient and Post Encounter Charges
3 Update Records and Send Claims When You Receive Updated Insurance Information

What is Your Practice’s Grace Period?

Your practice should define how much time you allow for parents to enroll their newborn and circle back with you so that claims can be filed to insurance.

You could decide to delay billing for newborn services for 30 days, for example. You will use this grace period value in the steps below.

Add the Patient and Post Encounter Charges

When you add the newborn patient to your PCC system, you’ll give them a “Newborn” policy with an end date and enter a Hold Bill Until date. Follow the steps below:

Add the Newborn Policy to the Patient

Add the “Newborn” insurance policy to the patient’s policies. Set the “End Date” for the policy to the number of days of your grace period past the patient’s DOB.

Enter a “Hold Bill Until” Date for the Family

In the Demographics section of the chart, enter a “Hold Bill Until” date that is equal to the patient’s DOB plus your practice’s grace period.

This will prevent statements from being sent home until that date.

Post Newborn Encounter Charges

Use the “Create Encounter” button in the Billing History to enter hospital encounters. Use the Post Charges button on the Schedule screen to bill for in-office visits.

Since the patient has a “Newborn” insurance policy and the account has a “Hold Bill Until” date:

The encounter charges will pend to the “Newborn” insurance policy but will not generate a claim.
Unpaid encounter charges will be the billing account’s responsibility. However, the family won’t receive a statement until the Hold Bill Until date.
The family has time to obtain insurance coverage and contact you to update the patient’s record. If they fail to do so before the end of your practice’s grace period, they’ll receive a statement for the amounts due.

Newborn charges will be added to your practice’s A/R. You can review and track charges pending the “Newborn” insurance group using PCC’s standard insurance A/R reports or you can review the Account Balances component in the patient’s chart.

Update Records and Send Claims When You Receive Updated Insurance Information

Once the family has verified their newborn’s coverage, follow these steps:

Update the Patient’s Policies

Add the new insurance information to the patient’s policies. For the “Start Date”, enter the policy’s effective date.

Expire the “Newborn” insurance by entering an end date before the patient’s DOB.

Edit Each Encounter

In the patient’s Billing History, select an encounter that needs a new claim.

Update Responsible Party and Personal Amount Due

Ensure that the new policy is now listed as primary and, if needed, adjust the “Insurance” for each charge to be the primary policy. Change the Personal Due amount to zero.

Queue Up a Claim and Save Changes

Double-check that the “Queue a New Claim” box is checked and then click “Save + Post”.

Edit Charges and Queue a Claim For Any Subsequent Encounters

Repeat these steps for any other encounters in the patient’s Billing History that should now be billed to the family’s insurance.

When you next run claims, your PCC system will process and submit the claims to the insurance payer.

Here are some related articles in Billing and Practice Management > Bill Insurance:

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What is Your Practice’s Grace Period?

Add the Patient and Post Encounter Charges

Update Records and Send Claims When You Receive Updated Insurance Information

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