Billing

Patient Billing

Patient billing involves collecting payments from Patients for their outstanding balances.

This guide provides an overview of managing the Patient Billing process for the Practices handling Insurance-based and Cash-only/Self-pay Invoices.

1. Insurance-based Invoices: These are Invoices with outstanding Patient balances that remain after Insurance Claims have been processed.
2. Cash-only/Self-pay Invoices: Self-pay Invoices are generated for services where the Patient is directly responsible for payment.

By following the recommended workflows in the guide, Practices can ensure timely payment collection and improve overall billing efficiency.

• Handling Insurance-based Invoices
  1. Managing Overpaid Invoices
  2. Apply Patient Credits to Outstanding Invoices
  3. Charge Patient's Card on File
  4. Send Invoices to Patients for Payment Collection
  5. Set Up Patient Payment Plans
• Handling Cash-only/Self-pay Invoices
  1. Managing Overpaid Invoices
  2. Apply Patient Credits to Outstanding Invoices
  3. Charge Patient's Card on File
  4. Send Invoices to Patients for Payment Collection
  5. Set Up Patient Payment Plans
• Sending Patient Reminders for Outstanding Invoices
• Sending Outstanding Invoices to the Collection Agency
• Configuring Patient Billing Settings
• Patient Statements

Handling Insurance-based Invoices

Practices can send Invoices to Patients to collect any remaining balances after Claims have been fully processed.

Practices that have enabled secondary claim processing typically wait until the secondary Claims are processed to ensure all insurance responsibilities are accounted for before sending Invoices for payment collection.

To enable secondary claim processing, navigate to 'Settings > Billing-Claims > Claim Settings > Secondary Claim Processing Settings'. To learn more about generating Secondary Claims, Visit Here.

While the following steps are not mandatory, Charm recommends following this workflow before sending an invoice to a patient for payment collection to ensure efficient management of outstanding invoices.

Practices can identify insurance-based Invoices by using the ‘With Due & PR’ filter under the ‘Billing > Invoices > Search Options 1 > Outstanding Invoices (Initial Communication)’ section.

1. Managing Overpaid Invoices

Before billing a Patient for outstanding Invoices, it is important to review any overpaid Invoices. Applying overpaid amounts towards outstanding balances helps to reduce Patient dues and ensures accurate billing.

To manage the Invoices with overpayments, follow the steps below.

1. Navigate to 'Billing > Invoices > Search Options 1'
2. Select the 'Outstanding Invoices (Initial Communication) > Invoices with Excess Payments' filter option.
   
3. This lists all Invoices with a negative due balance, indicating an excess payment or adjustment.
4. Transfer the overpayment amount to the Patient’s account as a credit by editing the Invoice and adjusting the Invoice Amount.
5. Once moved to Patient Credits, it can be used for the Outstanding Invoices as discussed in the next section.

2. Apply Patient Credits to Outstanding Invoices

Before sending Invoices to Patients, verify whether there are existing credits in their accounts. Apply these credits to reduce or clear outstanding balances.

To identify such Invoices, follow the steps below.

1. Navigate to 'Outstanding Invoices (Initial Communication) > With Due & PR > With Due, PR & Patient has Credits'.
   
2. This lists Invoices with Due, PR, and Patient has Credits.

To apply the available Patient Credits to the outstanding Invoices, follow the steps below.

1. Click the Patient Name link to navigate to the Patient Dashboard.
2. In the Receipts tab, sort by the 'Unused Payments' column to identify Receipts with unused payments. Alternatively, select 'Receipts with Unused Payments' from the 'Watch List'.
   
3. Edit the Receipt and apply the unused payments to the corresponding Invoices.

If there are still outstanding Invoices with Patient Responsibility after applying the Patient Credits, those Invoices can then be billed to the Patient. This ensures efficient utilization of Patient credits, reducing their dues before initiating billing.

3. Charge Patient's Card on File

If a Patient has a card on file saved in Charm, and the Practice has obtained consent to charge the Patient’s card, their outstanding dues can be cleared by processing the payment using the saved card.

Follow the steps below to process payments using the Patient’s card on file.

1. Navigate to 'Outstanding Invoices (Initial Communication) > With Due & PR > With Due, PR & Patient has Card on File'.
   
2. This lists all Invoices with Due, PR, and the Patient has Cards on File.

   Note: This functionality is available only for Practices using the Bluefin Payment Gateway.

3. Select the Invoices and click the 'Charge Card on File' button to process payments for all selected Invoices.
   
   

4. Send Invoices to Patients for Payment Collection

After following the steps to apply for Patient credits and charge the card on file, any remaining outstanding Invoices can be sent to the Patient for payment collection.

1. Navigate to 'Outstanding Invoices (Initial Communication) > With Due & PR > With Due and Patient Responsibility'.
   
2. Select the Invoices and click 'Send Invoices'.
   
3. Send Invoices with the Payment link through the Patient's available communication modes, such as Email, PHR, or Cell Number. To learn more about sending Invoices through different communication modes, Click Here.
4. Patients can then pay their balances using the payment links.

5. Set Up Patient Payment Plans

Practices can offer customized payment plans for Patients, allowing them to settle their outstanding balances in manageable installments.

Navigate to 'Receipt > Recurring Payments > + Recurring Payments' and set up Recurring payments tailored to specific Invoices or outstanding balances.

For more information on Recurring Payments, Click Here.

Handling Cash-only/Self-pay Invoices

Patient billing for cash-only/self-pay Invoices follows the same process as billing for insurance-based Invoices, with one key distinction: the ‘With Due & No Claim’ filter is used under ‘Outstanding Invoices (Initial Communication)’ to identify cash-only/self-pay Invoices.

Follow the steps below to handle Patient billing for cash-only/self-pay Invoices.

1. Managing Overpaid Invoices

To manage the Invoices with overpayments, follow the steps below.

1. Navigate to 'Billing > Invoices > Search Options 1'
2. Select the 'Outstanding Invoices (Initial Communication) > Invoices with Excess Payments' filter option.
   
3. This lists all Invoices with a negative due balance, indicating an excess payment or adjustment.
4. Transfer the overpayment amount to the Patient’s account as a credit by editing the Invoice and adjusting the Invoice Amount.
5. Once moved to Patient Credits, it can be used for the outstanding Invoices, as further discussed in the next section.

2. Apply Patient Credits to Outstanding Invoices

Follow the steps below to filter the Invoices with Patient credits and apply them to the outstanding Invoices.

1. Navigate to 'Billing > Invoices'
2. Filter the Invoices with due and Patient has credits using the 'Outstanding Invoices (Initial Communication) > With Due & No Claim > With Due & Patient has Credits' filter option.
   
3. Click on the Patient Name Link to navigate to the Patient Dashboard.
4. Edit the Receipt containing Patient credits and apply them to the Invoice.

If there are still outstanding Invoices with Patient Responsibility after applying the Patient Credits, those Invoices can then be billed to the Patient.

3. Charge Patient's Card on File

Follow the steps below to process payments using the Patient’s card on file.

1. Navigate to 'Outstanding Invoices (Initial Communication) > With Due & No Claim > With Due & Patient has Card on File'.
   
2. This lists all Invoices with Due, PR, and the Patient has Cards on File.

   Note: This functionality is available only for the Practices using the Bluefin Payment Gateway.

3. Select the Invoices and click the 'Charge Card on File' button to process payments for all selected Invoices.

4. Send Invoices to Patients for Payment Collection

The outstanding Invoices can be sent to the Patients for payment collection by following the steps below.

1. Navigate to 'Billing > Invoices > Outstanding Invoices (Initial Communication) > With Due & No Claim > With Due'
   
2. Select the Invoices and click 'Send Invoice' to send Invoices with a payment link to the Patients.
3. Patients can pay their balances using the payment links.

5. Set Up Patient Payment Plans

Practices can offer customized payment plans for Patients, allowing them to pay their outstanding balances in manageable installments.

Navigate to 'Receipt > Recurring Payments > + Recurring Payments' and set up Recurring payments tailored to specific Invoices or outstanding balances.

Sending Patient Reminders for Outstanding Invoices

Practices can effectively follow up with Patients by sending reminders for outstanding Invoices.

Follow the steps below to send reminders for the outstanding Invoices.

1. Navigate to 'Billing > Invoices > Search Options 1'
2. Select the 'Patient Billing - Reminders' option.
   
3. Practices can filter the Invoices based on the first invoice sent date for sending Reminders.
   
   • Filter For Insurance-based Invoices: Invoices with Due and PR
     Reminder Levels:
     1. Reminder 1: Outstanding for over 30 days from the First Invoice Sent Date.
     2. Reminder 2: Outstanding for over 60 days from the First Invoice Sent Date.
     3. Reminder 3: Outstanding for over 90 days from the First Invoice Sent Date.
   • Filter For Self-pay Invoices: Invoices with Due and No Claim Reminder Levels:
     1. Reminder 1: Outstanding for over 30 days from the First Invoice Sent Date.
     2. Reminder 2: Outstanding for over 60 days from the First Invoice Sent Date.
     3. Reminder 3: Outstanding for over 90 days from the First Invoice Sent Date.

Late Payment Fee

If a payment is overdue, Practices can send reminders along with the Late Payment Fee if required by the Practice.

For example, Practices can apply a late payment fee to Invoices that have been outstanding for over 30 days. Follow the steps below to send Invoices with a late payment fee.

1. Navigate to 'Billing > Invoices > Search Options 1 > Patient Billing'
2. Filter Invoices that have been outstanding for more than 30 days.
3. Select the Invoices from the list.
   
4. Click the 'Actions' button and select the 'Add Procedures to Invoices' option.
5. Select the appropriate Late Payment Fee Procedure Code to apply the fee to all selected invoices.
   

This ensures overdue payments are managed efficiently and aligns with the Practice’s policy.

Visit Here to learn more about adding Procedure Codes to multiple Invoices.

Patient Billing Settings

The Patient Billing settings allow Practices to customize the billing parameters for an efficient workflow.

Navigate to the 'Settings > Billing > Billing Settings > Patient Billing Settings' section.

• Send Invoice to Patients with only the Patient Portion of Invoice Due:
  This setting enables Practices to enter an amount submitted on a Claim so it can be excluded from the Patient's Invoice, ensuring that only the remaining balance specific to the Patient is shown.
• Invoice Label Selection:
  Choose the label to be displayed on the Invoice.
• Email Notifications for Invoices, Receipts, and Statements:
  Send an email notification to the Patient's Email ID each time an Invoice, Receipt, or Statement is sent to the Patient's PHR account.

1. Default Options for Sending Invoices
2. Default Options for Sending Patient Statements
3. Default Options to Re-send Invoices
4. Other Default Options
5. Default Options when Card on File is Selected

Default Options for Sending Invoices

Practices can choose preferred settings for automatically sending Invoices.

• Choose the delivery modes or set a preferred order for sending Invoices:
  1. Send Through Selected Modes: Choose one or more default modes (PHR, Email, or Cell Number) to send Invoices. The selected modes will be chosen automatically while sending Invoices.
  2. Send Based on Preferred Order:
     • Arrange the preferred modes in priority order (e.g., PHR > Email > Text Message (Cell Number)).
     • The selected order will be chosen automatically while sending Invoices.
     • You can choose to send Invoices through:
       1. Only the first available mode will be used (e.g., If a Patient has both PHR and Email, the Invoice will only be sent via PHR).
       2. The first two available modes will be used (e.g., If a Patient has both PHR and Email, the Invoice will be sent through both).
• Choose the default 'Send-Invoice - PHR Message' template:
  To create or edit the template, navigate to 'Settings > Templates > Practice Templates'
• Choose the default 'Email Template for sending Invoice via Email in addition to PHR':
  This template will be selected automatically when the 'Send to Email too' option is enabled under the 'Send Invoice > Send to PHR' section.
• Choose the default 'Send Invoice - Email' Template:
  To create or edit the template, navigate to 'Settings > Templates > Practice Templates'

Default Options for Sending Patient Statements

Practices can configure the default options for sending Patient Statements.

• Choose the default 'Send Statement - PHR Template':
  To create or edit the template, navigate to 'Settings > Templates > Practice Templates'
• Choose the default Email Template for sending a Statement via Email in addition to PHR:
  This template will be selected automatically when the 'Send to Email too' option is enabled under the 'Send Statement > Send to PHR' section.
• Choose the default 'Send Statement - Email Template':
  To create or edit the template, navigate to 'Settings > Templates > Practice Templates'
• Choose the default Practice Member for the 'From' field, when sending an Invoice or Statement to PHR:
  The responses from the Patient's PHR will be directed to the selected Practice Member.

Default Options to Re-send Invoices

Practices can automatically resend Invoices to Patients whenever there is a change to the Invoice Due. This functionality applies only if the Invoice has already been sent initially.

• Re-send the Invoice to the PHR account:
  Enable this option to resend the Invoice to the PHR account when the Patient pays or when the Invoice Due changes.
• Choose the default template for re-sending the Invoice to PHR Account:
  The Invoice will be sent to the PHR account using either the last used or preferred template based on the selection.
• Re-send the Invoice to the Email ID:
  When enabled, Invoices will automatically be resent to the Patient's Email ID upon payment or 'Invoice Due' changes. This only applies if the Invoice has been previously sent by the Practice.
• Choose the default template for re-sending the Invoice to the Email ID:
  The Invoice will be sent to the Patient's Email ID using the last used or preferred template based on the selection.

Other Default Options

• Choose the 'Guarantor Email ID' option by default in 'Send Invoice to Email' & 'Send Statement to Email':
  Enabling this setting will pre-select the 'Send to Guarantor' checkbox by default on both the 'Send Invoice' and 'Send Statement' pages.
• Auto-select the 'Exclude Invoices with Patient having PHR Account' option, while sending multiple Invoices to the Patient's Email ID:
  This setting will prevent sending Invoices to Patients who have a PHR account.

Default Options when Card on File is Selected

Practices can configure the default options when the Patient's Card on File is used.

• Store the card on file while the Patient pays for Invoices from PHR:
  When this option is enabled, the Patient's card information will be saved automatically whenever they make a card payment from their PHR account.
• Allow Patients to delete the card on file from their PHR account:
  Once enabled, Patients can remove their saved cards directly from their PHR account.