Patient Accounts

A patient receives services from the provider and then the patient is responsible for paying the provider in exchange for those services. The patient may pay for the services directly or the patient may have one or more payers that pay the service costs for a patient. The patient account is described in the following sections of this chapter:

The patient account is used to track the money the patient has contributed to the cost of services rendered. There are several different scenarios that determine how much a patient owes. They are:

• Patient pays all charges. When the payment is made, it is recorded in the patient account. There are two options for entering a payment:
1. from the Patient Detail dialog, select the account tab and then select the New button.
2. from the Encounter dialog in the upper-right corner, above the Account History table is a New button that, when selected will open a new payment dialog.
• Patient co-pay - the contract between a patient and a payer specifies how much money the patient is to pay for and encounter. Sometimes it is a fixed dollar amount and other times it is a percentage of the total allowed cost of the encounter.
• Patient Deductible - the contract between a patient and a payer also specifies how much money the patient is to pay over and above the co-pay before the payer will start to pay for services.
• Non-Covered Services - the contract between a patient and a payer would also specify that some services would not be covered by the contract. In those cases the patient is responsible for the cost of service.

The patient account tracks several different transactions:

1. credit - all patient payments made to the practice
2. debit - the removal of money from the account to balance an encounter.
Debits happen automatically when all procedures for all claims have a payment applied to them. A debit will be entered into the account even if there isn't enough money in the account to cover the cost. This make the balance negative that means the patient owes the practice money.
3. transfer - move money between patient accounts
4. rebate - return of overpayments to patient

Account Interactions in other dialogs

There are two TFM screens that provide access to the patient account. One is through the the Account tab in the Patient - Account screen and the other is through the Encounter Summary screen.

Reports

The patient account is well documented in the Reports section. There are several different reports that reference the Patient Account. These include Patient Billing and Aging and in the summary reports of Patient Payments.

User Interactions with Patient Account Dialog

This Account Edit dialog provides a means for entering a new payment into the patient account or for editing an existing payment. This dialog is divided into three sections:

• top - some useful information
• middle - the editable information
• bottom - the buttons for controlling the dialog

TOP section displays useful information that can't be changed here:

• the name of the patient account
• the co-pay amount
• the current balance of the patient account

• transaction date - is the date the money was received
• transaction amount
• transaction type
• Credit - select if amount is going into the account
• Rebate - select if amount is being returned to patient
• method of payment
  • Cash - select if cash was collected
  • Check - select if a check was collected
  • Charge - select if amount is paid with credit card
• check number (optional) used for tracking the check
• note - a free form text field (optional)

BOTTOM section is the control buttons:

• Cancel - don't save any of the information and close the dialog
• PDFdoc - create a PDF document with the patient account information. The document is written to the Reports directory specified in the preferences.
• Save - save the current information and close the dialog

Special Cases

TFM makes the normal patient account interactions simple however, it also handles the odd problems that come up in the day-to-day interactions.

Cash Payments

This process is used when a patient has no insurance or when the patient has insurance that you don't carry. Normally, TFM will automatically debit that patient account if the encounter has a balance after all procedures of all claims have been paid. So, to debit a patients account for a patient that pays cash for an encounter, take the following steps:

1. Create an encounter


2. add the procedures to the encounter
• (Note: There are no claims for this encounter.)


3. select the Debit Account button
• causes a new dialog to appear

4. select the Debit Patient Account for Total Charge button

NOTE: The Total Charge amount shown above this button will be subtracted from the patient account. In the example above a total of $95.00 will be subtracted from the patient account.

Adjustments to Charge

In special situations it is desirable to make a change to the charge for a procedure. For example, a patient can only pay part of the charge or you choose to no charge a patient, the charges will need to be modified. The objective is to adjust the charge for the special case while leaving the procedure charge in the database unchanged. The steps required to do this are:

STEPS

1. Create an encounter
2. add the procedures to the encounter
3. select the Modify Charge button
• opens a dialog (see below)

The Encounter charges are listed in the table in the upper left corner of this new dialog. To make a change to one of the procedure charges:

4. select a procedure in the table with double-click of mouse
• causes the Edit section to be loaded with the procedure & charge


5. in the field labeled New ... enter the new charge


6. select the Apply Change button
• causes the charge in the procedure list to be changed


7. when finished modifying the charges ... select the Finished button or if the patient is paying cash for the encounter (see previous section) select the Debit Patient Account for Total Charge button.

Transfer money to another account

This is a situation where one patient has a positive balance in their account and they would like to transfer some of that amount to another patient. This usually occurs between family members. Both patient accounts will have this transaction recorded. One will show a transfer out and the other will show a transfer of the money into the account.

To start the process execute the following steps:

STEPS

1. Open Patient Detail Dialog
2. Select the Account tab, found in the middle of the dialog

3. select the Transfer button, found next to the account table
• opens a dialog (see below)

The dialog will open with just the patient name and their current balance displayed. In this example the patient name is Alice E. Patient with an account balance of $35.00. These are not editable fields. You can either transfer money into or out of the current patients account. To change which way the money is to be transferred simply select the Direction button.

4. select the Set button, to select another patient
• opens a Find Patient dialog


5. select the second patient
• this example has selected Arnold E. Lastname with and account balance of $200.00


6. enter the amount to transfer into the field in the upper right corner
• this example has the amount of $15.00 entered.


7. the last step is to select the Transfer button

At this point, TFM will debit one account and transfer that amount into the second patient account. In this example, Arnold E. Lastname's account will be reduced by $15.00 and Alice E. Patient's account will increase by $15.00.