PERMISSIONS REQUIRED: Clinic Staff must have Administrator, Billing Manager, Clinical Director, Front Office, Operations Manager, PTA, Staff Therapist, or Therapy Student Permissions assigned in order to manage Case Info.
Other Case Info: Estimated Payment Schedule
In the therapy environment, it is difficult to know the exact charge for a patient before they leave your clinic. With this in mind, the system uses an Estimated Payment System, which allows you to enter a payment schedule for a patient that determines how much they owe on each visit.
Choosing Edit Estimated Payment Schedule brings up the following dialog:
The Edit dialog works the same as Prescriptions and Diagnoses. You can Add, Edit or Delete payment ranges from here. Clicking Add brings up the following dialog:
Multiple ranges can be entered to allow charging of different ranges for a given set of visits.
The following are a few example scenarios of patients, their estimated payment schedules, and how they are handled:
- A patient has a co-pay of $10.00 and has a 10 visit cap, at which point the insurance will stop paying. A deal has been worked out with the patient to charge them $65.00 per visit after the 10th visit, but until that time they will owe their $10.00 co-pay. This would require 2 estimated payment ranges. The first one would be for all visits greater than or equal to 1 to pay $10.00. The second one would be for all visits greater than or equal to 11 to pay $65.00.
- A patient has Health Care United as their carrier. From past history, we know that HCU pays $85.00 a visit. The patient has an 80/20 plan. From this, we can estimate that the patient will owe 20% of $85, or $17.00 a visit. This patient also has a $100.00 max out of pocket whereby the insurance carrier will then pay 100%. This means that on the first 5 visits you will collect $17.00 for a total of $85. On the 6th visit, you will collect $15.00 and on every visit after that, you will collect nothing.