Post Charges and Check Out Patients in PCC EHR

After the clinician charts a visit, phone note, or portal message and selects diagnoses and procedures on the electronic encounter form, you can “check out” the encounter by posting charges.

As you post charges, you can review and update patient information (like insurance eligibility), double-check the linking and codes that the clinician selected, and post any payments received.

Watch a Video: You can watch a quick video introduction to posting charges in PCC EHR.

Contents

Overview Procedure: Post Charges and Payments in PCC EHR

Read the procedure below to learn how to post charges in PCC EHR.

Click “Ready to Post” on the Schedule or Messaging Queue

Find an encounter that is ready to post on either the PCC EHR Schedule screen or the Messaging queue and click “Ready to Post”.


PCC EHR will open a Post Charges window.

Which Encounters Are Ready?: Review the additional sections below to learn more about how an appointment becomes Ready to Post, what the Signing column indicates, and how to post charges for encounters without appointments.

Optional: Review Patient History, Patient Details, and the Chart Note

You can review your practice’s custom Patient Details protocol to check eligibility, update insurance policies, or check demographic information.

Click “History” to visit the patient’s chart history and review previous chart notes or other encounters. Click “Visit Note” in the lower-right corner to open a copy of the encounter’s chart note.

Click “Post Charges” to Open the Post Charges Protocol

When you are ready to review and update charges, payments, and claim information, click on the “Post Charges” navigation button.

Optional: Adjust the Encounter’s Billing Place of Service or Rendering Provider

If you need to change the billing place of service or provider of service, you can do so in the Appointment Details component at the top of Post Charges.

For example, if you are posting charges for a telemedicine encounter, you may need to change the billing place of service for some carriers.

Optional: Adjust the Encounter’s Diagnoses and Procedures

Use the Diagnoses and Procedures components in the Post Charges protocol to review and update diagnoses and procedures for the encounter.

The Diagnoses and Procedures components display all the diagnoses and procedures that the clinician made ready for billing on the electronic encounter form. The “Source” column in the Procedures component tells you where each charge came from, and if it originated from an order you can click to view the order’s details.

If you need to add a modifier to a code, you can click on a procedure to select any variations in your practice’s customizable Procedures table.

You can optionally add diagnoses or procedures that you need for billing.

New Diagnoses and Procedures Will Not Appear on the Chart Note: While a biller can add diagnoses and procedures on the Post Charges protocol, those items will only appear in the billing record and on the claim. For most situations, the clinician should chart all procedures and diagnoses on the chart note.

Optional: Adjust Linking and Other Procedure Details

You can adjust linking in either the Diagnoses or Procedures components. You can click to link or unlink all procedures, or open a selection window.


In the Procedures component, you can also set which diagnosis is primary for each procedure.

You can adjust the number of units, switch to a secondary insurance or “Self Pay”, and change the amount due personal (adjust the copay, for example).

Complex Billing Configuration Available: As you work, you may see due amounts change based on your selection and your practice’s configuration. PCC supports configurations for price schedules, copay rules, capitated plans that adjust off charges immediately, and Medicaid plans (where nothing reverts to personal due). Your practice can customize the billing behavior of any procedure for any insurance policy. The correct amounts and adjustments will appear in the Procedures component automatically.

Optional: Select a Billing Provider or Enter Additional Claim Information

If an encounter needs to be billed under a different provider, requires a prior authorization number, or has additional details that should appear on the claim, you can enter that information in the Claim Information component.

When you post charges for an accident, for example, the insurance claim must include accident information. Similarly, claims can include referring provider information.

Who Are the Service and Billing Providers?: PCC EHR automatically indicates that the provider scheduled for the patient is the Service Provider and the Billing Provider. You can adjust who saw the patient in the Appointment Details component at any time–either in the chart note, or later in the charge posting process. If the encounter should be billed for a different provider, you can adjust that here in the Claim Information component.

Terminology for Billing Providers: PCC uses the terms “Service Provider” and “Billing Provider” for the clinicians who saw the patient and for whom the visit is billed. The CMS-1500 specification (and some health care organizations) use different terms: Rendering Provider and Locum Tenens. Additionally, sometimes the term “Billing Provider” refers instead to the pediatric practice, and is associated with a practice’s Tax ID.

Review Balances and Totals

What amount is due personal for this encounter? Did the family pay part of their balance today? Use the Payments component to review personal due totals and enter payments.

If today’s procedures result in a personal balance, you’ll see the total for the patient at the top, next to “Today’s Visit”. If the patient’s billing account has a previous balance, you’ll see that as well. If the family already paid the copay during Patient Checkin, you’ll see that TOS payment on the screen.

Why Do I Have a Previous Balance?: As you post a charge and enter payments, you may see a previous balance. That balance could be for charges for any patient who shares the same guarantor (or “bill-paying”) account. You can review details for the personal balance on the Patient Details protocol.

Enter Payments or Discounts for the Encounter

Select a Payment Type to begin entering a payment.



PCC EHR enters the amount due in the Amount field for you. You can adjust that amount if the parent is not paying the full amount today. You can optionally adjust how much will be applied to today’s visit or the account’s previous balance.

If you select a time of service discount as your payment type, you can optionally enter a percentage as the amount and PCC EHR will do the math for you. Once you enter a discount, PCC EHR will update the Procedures component to illustrate the amount that was discounted for each charge.

As you enter payment or discount information, the ledger in the Payments component will update to reflect the payment and the new resulting balance.

Note that payments and discounts are not saved until you click “Save + Post”.

Click “Save + Post” to Finish Posting and Queue Up a Claim

When you finish reviewing and adjusting procedures, diagnoses, linking, claim information, and payments, click “Save + Post” to post the charges. (If you want a receipt right away, you can first click “Generate a Receipt”.)


The Schedule queue displays that the encounter’s charges are posted.

What Happens Next?: As soon as you post charges, PCC queues up a claim. Your practice can review, adjust, or delete charges and payments using Correct Mistakes (oops) in the Practice Management window. Later, your billers can generate claims, which will automatically review claim information for errors and then send claims electronically to the payers.

Optional: Print a Receipt

Does the family need a receipt for today’s visit? You can click the “Generate a Receipt” checkbox before you save charges, or click the “Posted” billing status to return to Post Charges and click “Generate a Receipt”.


Optionally, your practice can also print receipts during Patient Check-In. See the sections below for more information on receipts.

Return to an Encounter and Post More Charges and Payments Later

If a clinician returns to the chart note and adds additional diagnoses or procedures, you can spot that in the Billing Status column. (You can also use reports to find all visits with unposted charges.)

Click “New Items” to reopen the Post Charges tool and add the additional items to the claim.


You can review and enter any new procedures or diagnoses, adjust linking, add new payments, and click “Save and Post” to adjust the queued claim.

When is an Appointment Ready to Post?

As you review the Schedule screen, how can you tell that an appointment is ready to post?

Use the Billing Status and Signed columns to identify which appointments are ready to post and who has signed the appointment’s chart note.

When a clinician finishes adding diagnoses and procedures to a chart note and then completes the electronic encounter form, they click “Make Ready For Billing”. That updates the status for the appointment to “Ready to Post”.

You may also want to review whether or not the clinician has signed the chart note, and check whether it has been co-signed, if required. While you can enter charges for an encounter that has not been signed, your practice’s billing policy may indicate that you wait for the chart note to be signed beforehand.

An orange name indicates that a chart note requires co-signing.

Can You Post Charges While Another User Edits the Account’s Charges?

If someone in your practice is modifying charge history in the Correct Mistakes (oops) program in Practice Management, you will see a warning message when you attempt to post charges in PCC EHR.

You can continue, and even save new charges and payments, but your changes will be held in limbo until the other user leaves oops for the account/patient. When that user finishes, PCC will automatically add the new charges to the appropriate account records and queue up a claim (if appropriate).

Post Charges for Phone Note and Portal Message Encounters

PCC EHR allows providers to bill for services rendered in a phone note or portal message. Billers can see which phone note and portal message encounters are ready to post in the Messaging screen in PCC EHR.

Phone note and portal message encounters must be posted in PCC EHR. They are not visible in the Partner Post Charges (checkout) program in Practice Management.

To post charges for a billed phone note or portal message encounter, open the Messaging tab in PCC EHR and click Ready to Post.

Post charges like you would for a regularly scheduled appointment: review the patient details ribbon, and post and link procedures and diagnoses. Click Save + Post to batch a claim for insurance.

Check Insurance Eligibility for Phone and Portal Encounters While Posting Charges: The Insurance Eligibility component in Post Charges is the only place you can verify insurance eligibility information for billed phone note and portal message encounters. It is not possible to record eligibility notes or verification statuses for phone and portal encounters.

Post Charges for Hospital Visits and Other Charges with No Appointment

When you need to post charges for a hospital visit, or post charges that are not associated with an appointment, phone note, or portal message in PCC EHR (such as form fees), use the Partner Post Charges (checkout) program in the Practice Management window.

PCC is bringing these and other billing features into this interface in upcoming releases.

Review and Update Patient and Encounter Information as You Post Charges

You can post charges for some appointments in seconds. For other appointments, you may need to update insurance information, review encounter history, look back at the chart note, and more.

As you post charges, you have many tools available to review and update patient information or research what happened during the encounter.

The sections below will show you how to find the information you need to post charges and perform other billing tasks.

Review the Patient Details Ribbon: Insurance, Demographics, and More

Use your practice’s customizable Patient Details protocol to review and update eligibility, insurance policies, demographics and more.

Use the navigation buttons to jump to any section of the protocol. If you’d like to add other PCC EHR components to the protocol read Configure Your Practice’s Patient Details Protocol for Post Charges, or contact PCC Support for help.

Adjust Billing Place of Service for Telemedicine Encounters

When you schedule and perform a telemedicine visit, it makes sense to use your office location–the doctors can see their whole schedule, and your practice can see what’s happening at a glance. When it’s time to bill, however, some carriers require a special telemedicine place of service.

When you post charges from PCC EHR’s Schedule queue, the Billing POS is a drop-down menu. It includes the appointment location and any locations set as a telemedicine location. You can select your new billing location, and complete posting your charges as usual.

To learn more, read or watch Schedule, Chart, and Bill for a Telemedicine Encounter (Video, Article).

Research Previous Personal Balances

As you post charges, you may notice a “Previous Balance Amount” line in the Payments component ledger. The amount is the total of any past, unpaid charges for all patients who share the same guarantor (or “bill-paying”) account.

You can review details for the personal balance on the Patient Details protocol.

Click the disclosure triangle for “Encounters with Outstanding Personal Balances” to review details of all encounters with unpaid personal balances.

Open Documents Attached to the Encounter

Did the front desk scan the insurance card, a form, questionnaire, or some other item? Is lab information attached to an encounter? You can review any documents attached to an encounter in the Post Charges workflow.

To jump to attached documents, click the “Documents” navigation button on the Patient Details protocol. (If there are no documents attached to the encounter, this button will not appear.)

If an insurance card, form, or other document is attached to the encounter, it will appear at the bottom of Patient Details. Click “View Document” on a document to open it.

Review the Patient’s Complete Visit History

Click “History” to visit the patient’s chart history and review previous chart notes or other encounters.

Open Today’s Visit Chart Note in a New Window

Click “Visit Note” in the lower-right corner of Post Charges to open a copy of the encounter’s chart note in a separate window.


You can keep the window open, side-by-side with Post Charges, so you can review it as you update diagnoses and procedures.

Review and Update Billing Procedures As You Post Charges

In the Procedures component in Post Charges, you can set whether or not a procedure appears on the claim, adjust units, and change the copay amount for a procedure.

Learn about other, less common actions in the sections below.

Post Administrative Fees, Form Fees, or Add Other Billing Procedures

As you post charges for an appointment, you can add any procedure code or billing procedure in the Procedures component. For example, you might charge for certain forms or records.


Your practice can configure procedures with unique billing behaviors. For example, the Medical Records fee above will automatically not appear on the claim. Also, your practice can configure a set price for a procedure, or have a default price of $0.00 so that the biller can enter the total fee.

Add a Modifier to Visit Code, or Pick a Different Version of a Procedure Code

When you need to add a -25 or other modifier to a code, click on the procedure in the Procedures component.

PCC EHR automatically displays all the procedures that have the same base code. If you are posting a complex visit that requires a modifier, you can pick the modified code and PCC EHR will update the prices accordingly.

In addition to adding a modifier, your practice can use this to specify a different version of the code that you track for billing purposes. For help setting up and configuring your practices procedures, codes, and prices, contact your PCC Client Advocate.

Review the Source of Procedures in Post Charges, Review Procedure Order Details

How did each procedure end up in Post Charges? Use the “Source” column in the Procedures component to explain the origin of each procedure. For example, it might come from a lab, from an immunization, or you may have added it manually in Post Charges.

When a clinician creates an order for an immunization, screening, or other service, PCC EHR can automatically add appropriate procedure codes to the electronic encounter form. The clinician manually selects a visit code (and sometimes other codes) on the electronic encounter form. Then the clinician makes these codes “Ready For Billing”, which causes them to appear in Procedures in the Post Charges protocol. Finally, the biller can also manually add procedures before they queue up the claim.

For some orders, you can click on the “Details” link, as shown in the image above, to learn more about the order that led to the billing procedure code.

Configure Orders to Trigger Specific Procedures: Your practice can customize exactly which procedure codes should automatically be added to the encounter form for each lab, screening, or other order. See Configure PCC EHR Billing and the Electronic Encounter Form to learn more.

Post a Procedure With No Linked Diagnosis

On a claim, all procedures must be linked to one or more diagnosis. If you attempt to post a procedure that is not linked to a diagnosis, PCC EHR will stop and ask you to link before continuing.

Change the Order of Procedures On An Insurance Claim

Some payers may require the E&M code to appear first, or have other requirements for the claim. Your practice may want to sort the CPTs so they appear in a certain order.

Your PCC Client Advocate can adjust the claim processing for each payer and set a priority order for procedures so they appear in the correct order on the claim. Contact your Client Advocate to configure your claims.

Post Payments and Generate Receipts as You Post Charges

To post a payment, select a payment type in the Payments component and enter the payment amount. Read below to learn more about payments, receipts, and the live ledger found in the Payments component.

Adjust How a Payment is Applied

For each payment, you can adjust what portion of the payment will apply to today’s visit or the past due balance.

In the above example, the user designated that the $207 check should fully apply to past-due balances and not to today’s required copay.

How are Payments Applied to Multiple Past-Due Balances?: If there are many unpaid previous balances, PCC will begin by applying payments to the oldest charges first. It will link the payment to charges in turn. Later, your practice can optionally unlink and relink payments in Correct Mistakes (oops) in the Practice Management window.

Add Multiple Payments

When a parent pays with multiple payments, you can add each payment and then adjust which payments apply to today’s encounter and which apply to past-due balances.

After you enter details for one payment, click “Add Payment” to create additional payment lines.


For each payment, you can select a payment type, enter an optional check number, and adjust what portion of the payment will apply to today’s visit or a past-due balance.

As you enter payments and make changes, the ledger in the Payments component will display the end result of your actions. The payments will not be posted or saved until you click “Save and Post”. All payments will appear on the receipt.

Enter Time-of-Service Discounts

As you post charges, you can enter a discount amount or discount percentage. There are two ways to enter a discount amount.

First, you can enter discounts for any procedure in the Discount column in the Procedures component.

If you type a percentage, PCC EHR will automatically calculate the discount amount.


The Payments component below will automatically fill out the details of the discount for you.

Alternatively, if you want to apply a discount towards all charges in the encounter, you can skip the Procedures component. In the Payments component, select a discount as the “Payment Type” and enter a percent or an amount.



The Discounts column in the Procedures component will automatically update with the discounted amounts. If you enter an exact discount amount instead of a percentage, PCC EHR will apply the discount to the procedures in order, starting from the top.

You can adjust discount amounts in either component, make other changes to the charges, or add additional payments for the remaining balance. Click “Save + Post” to finish posting the charges, payments, and discounts.

The Billing History section of the patient’s chart will display the discount along with other time-of-service payments or adjustments.

How Much Can I Adjust Off With a Time-Of-Service Discount?: Time-of-service discounts are for the amount due to the personal billing account of the patient, not for charges pending an insurance payer. You can only discount up to the total amount due personal on a charge.

Receipts Display Only Services and Payments: Discounts occur for a variety of reasons, some of which involve PHI or administrative decisions. Therefore Time-of-service discounts do not appear on the printed receipt. The Post Charges receipt only displays the billed services and any payments. To create a complete account history (including discounts), use the Account History (tater) report in Practice Management.

Configure Your Practice’s Default TOS Discount Type

When you enter a discount in the Procedures column while posting charges, PCC EHR automatically creates the Discount line in the Payments component for you.

If your practice has many different types of discounts or adjustments that you apply at the time of service, you can change the discount to a different type with the pull-down menu in the Payments component.

Use the Practice Preferences configuration tool to adjust your practice’s default TOS Discount. During your PCC 8.13 update, PCC copied your practice’s default TOS discount from the charge posting configuration in Practice Management. You can review and update this default in PCC EHR, and pick from any payment type in your PCC system that is marked as an “Adjustment” and is configured for charge posting.

Understand Payments Made for Siblings or Multiple Patients Who Share a Billing Account

As you post charges for a series of visits for patients with the same billing account, the Payments component will track your progress and let you know what amounts have already been posted for the account.

If you post the total of both copays for sibling patients during Patient Check-In, or do so when you post charges for the first sibling, the payment amount will appear in the ledger and you can adjust how much to apply to the encounter’s charges.

In example in the screenshot above, the $40 payment appeared in the Payments component, and the ledger was already showing that the family’s balance is $0.00. The user enters $20 into the “Apply to Today’s Visit” field to directly link that portion of the payment to this encounter’s charges. When they post charges for the sibling, they can apply the remaining $20.

Generate a Receipt for Today’s Payment

Your practice can generate receipts at many different times during a visit and the post charges process.

First, if your practice collects a copay or other payment during Patient Checkin, the front desk can generate a receipt for the payment right away.



Next, if you’d like a receipt to print out as soon as you save and post charges and payments, check the “Generate a Receipt” checkbox.


Finally, even after you save and posted charges, you can return to the Post Charges protocol for an encounter at any time and click “Generate a Receipt” to print another receipt.



Differences Between the Patient Checkin Receipt and Post Charges Receipt: When you generate a receipt from Post Charges, you will see more visit information including procedures and diagnoses. When you generate a receipt from Patient Checkin, you will only see the amount paid.

Apply a Past Credit from the Account to Today’s Visit

When the patient’s billing account has a credit, you may want to apply that credit to today’s copay or other balance amount on today’s charges.

Credits will automatically apply towards the account’s new balance. However, the past payment will not automatically be linked to today’s charges.

You will be able to link the credit to today’s balance in this interface in an upcoming release. For now, you can post the charges and any payments for today’s appointment. Later, your practice can link the credit to today’s balance in the Correct Mistakes (oops) tool in the Practice Management window.

Add More Diagnoses, Procedures, or Payments After You Post Charges

You can click on the “Posted” status to return to Post Charges to review what was posted and/or add additional diagnoses or procedures.

If a clinician returns to the chart note, adds diagnoses or procedures, and updates the Electronic Encounter Form, the Billing Status will display “New Items”.

Click “New Items” to reopen the Post Charges tool and add the additional items to the claim.


You can review and enter any new procedures or diagnoses, adjust linking, add new payments in the Payments component, and click “Save and Post” to adjust the queued claim.

Be aware that since charges and payments may have already been posted, the ledger in the Payments component will first display only totals and amounts for any new unposted charges for this encounter. Charges and payments you already posted are summarized below.

Edit or Delete Posted Diagnoses, Procedures, or Payments: If you need to delete or update charges or payments that are already on the claim, use the Correct Mistakes (oops) tool in Practice Management.

How to Find New Items: While you can easily spot the “New Items” on appointments for today, what about visits in the past? Use the Visits By Billing Status report in the PCC EHR report library to find all appointments that may include “New Items”.

  • Last modified: September 3, 2020