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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:

  • Description
  • Account Interactions and Reports
  • Patient Account Dialog
  • Special Cases include Cash, Adjustments and Transfers

  • 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:

    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.
    3. 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.
    4. transfer - move money between patient accounts
    5. 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.


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

    MIDDLE section titled Payment Detail are the payment edit fields.

    BOTTOM section is the control buttons:

    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

    3. select the Debit Account button

    1. 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:


    1. Create an encounter
    2. add the procedures to the encounter
    3. select the Modify Charge button

    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:

    1. select a procedure in the table with double-click of mouse

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

    3. select the Apply Change button

    4. 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:


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

    1. select the Transfer button, found next to the account table

    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.

    The next step is:
    1. select the Set button, to select another patient

    2. select the second patient

    3. enter the amount to transfer into the field in the upper right corner

    4. 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.

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