Track Newborn Charges and Delay Billing the Family
Does your practice delay newborn billing until the family updates their insurance? 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.
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Define Your Practice’s Grace Period
Your practice decides on a grace period, or how long you will delay billing for newborn charges. Your grace period is how much time you allow for parents to enroll their newborn. Before the end of that period, they need to circle back with you so that claims can be filed to insurance.
For example, you could decide to delay billing for newborn services for 30 days. You will use your grace period value in the steps below.
Add the Patient and Post Newborn 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. Enter an “End Date” equal to the patient’s DOB plus your practice’s grace period.
Enter a “Hold Bill Until” Date for the Family
In the Demographics section of the chart, enter the same date in the billing family’s “Hold Bill Until” field.
The Hold Bill Until date will prevent statements from being sent home until that date has passed.
Post Newborn Encounter Charges
For hospital encounters, use the “Create Encounter” button in the Billing History. For an in-office encounter, you can click “Ready to Post” on your Schedule screen.
Because 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 date of birth.
Edit Each Encounter
In the patient’s Billing History, select each encounter that needs a new claim and click “Edit Charges”.
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 “Primary”.
For each charge, change the Personal Due amount to zero.
Queue Up a Claim and Save Changes
Double-check that the “Queue a claim for this encounter…” 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.