Remittances and Accounts Receivable Follow-up.
In an effort to better service you, we are offering a Customized Clinic Specific Comparative Analysis.
The report will BENEFIT you by demonstrating YOUR clinic’s areas for revenue improvement and confirm best practices.
The Recording of the webinar, in case you missed it.
We had a lot of questions and have provided answers below. If you have further question please click the “Ask A Question ” button and we will be delighted to answer.
Advanced Billing Part 1
Q & A
How to apply the advance payment to a balance when the advance payment under a different attending provider?
You should be able to move money to any provider unless you have restrictions at the property level. Please call support to have them check this property: receipt.useadvance.forsame.lbar — Set this property to appropriate parameters for Clinics who want to restrict the use of Advance Amount for Location, Business Unit, Attending Doctor and Rendering Doctor for which it was collected. Select any or all from Values among the following: L- Location, B – Business Unit, A – Attending Provider, R – Rendering Provider. If not blank, it forces users to select only one Advance Entry from Used from Advance pop-up and compares the parameters set in this property with parameters of all the claims selected on Patient or Employer Receipt. If any of the selected claims have different parameters than the selected advance entry, it will give an error and force the user to change Advance entry or claim.
When posting Medicare remits I have to fix allowed amount is incorrect so there is a negative amount in the not allowed column. Can this be corrected???
Under Settings–configuration–Group Types:
For this in Setting >Configuration >Groups>Group Types>Non-System>BA (Payment Denied Reasons) and change the Spl Num Value to one of the following to have the positive or negative adjustment to show in that field:
5 – adjustment
16 – non covered
(All the following default as Pt Responsibility)
1 – deductible
2 – co-insurance
3 – co-pay
How to transfer Balance from patients bucket to insurance bucket
Remittances–Transfer Patient Credit – choose the patient to move money from, choose the amount to be moved, then choose the patient to move money too. Click Save.
Our practice no longer takes Medicaid, is there a way that it can be taken out of the system? The claims are auto-billing to Medicaid as the patient’s secondary insurance.
You can choose not to take Medicaid, but if the Primary payer auto sends the amount to Medicaid as the secondary payer, then that is out of your and PrognoCIS control. You will want Medicaid to actively handle these.
I have a lot of negative not covered amounts, so when I do it automatically it changes my secondary, and then when I go to post my secondary payments I can’t because they are more than what is due it says
You can enter the amount over the due amount as ‘Excess’. You will see the Excess button next to each line item in the remit.
Patient has two insurance – Medicare is primary and Cigna is secondary. Both insurance companies are paying as the primary insurance. How do I post this?
The one who paid primary in error should be marked as disputed, and the correct one posted as normal. If for some rare reason both are accurate for primary, and the amount paid is above the charge amount, you can enter the details in ‘Excess’
The payment was collected for a patient, however, it was posted to another patient’s account. How do I move from one account to the correct account?
Remittances–Transfer Patient Credit – choose the patient to move money from, choose the amount to be moved, then choose the patient to move money to. Click Save.
I was wanting to know if secondaries can be sent electronically?
Yes, most payers these days will accept secondaries electronically. I recommend trying and send it the first time, you will usually find out within 48 hours if they reject.