Financial

user manual financial suite 550 375 water street, vancouver, british columbia,canada, v6b 5c6 table of contents the billing view docid\ gqqqyh3fq9tudkqe5ur a opening the billing view main features of the billing view entering claim information docid\ gqqqyh3fq9tudkqe5ur a the billing panel toolbar actions viewing claims adding and altering medicare claim ranges docid\ gqqqyh3fq9tudkqe5ur a invoicing a private patient docid\ gqqqyh3fq9tudkqe5ur a creating an invoice the invoice window payment at time of invoice docid\ gqqqyh3fq9tudkqe5ur a using the “pay now” button making a payment at any time docid\ gqqqyh3fq9tudkqe5ur a making a payment from the appointment view making a payment from the transactions view invoicing a third party docid\ gqqqyh3fq9tudkqe5ur a to invoice a third party or organization how to add a new third party organisation reconciliation docid\ gqqqyh3fq9tudkqe5ur a reconciliation view receiving the remittance reconciliation filter accepting the gap financial reporting docid\ gqqqyh3fq9tudkqe5ur a report parameters financial corrections docid\ gqqqyh3fq9tudkqe5ur a common terminology find transactions docid\ gqqqyh3fq9tudkqe5ur a find accounts and end of financial period docid\ gqqqyh3fq9tudkqe5ur a viewing outstanding debts from control centre end of month printing transactions records statements docid\ gqqqyh3fq9tudkqe5ur a transaction list receipts the billing view opening the billing view the billing view is a means of reviewing and editing claims created from the appointment window before they are processed to the relevant payer it also allows you to manually add claims (for example, where a claim needs to be created without an appointment) once processed, claims are converted into invoices and stored, awaiting payment to open the billing view go to financial/billing on the main menu; or open the control centre, select the financial segment, and select billing hot tip for providers, there is also a billing view in the work centre, where only the provider’s own claims are shown header controls claims listfilter billing paneldisease coding assistant panel main features of the billing view the billing view consists of several toolbars and panels the central feature is the claims list, showing claims according to the criteria set up in the filter and the header controls use these to limit the display of claims, which can be overwhelming in number, to those of immediate interest in the first column of the claims list indicates that there is no error and the claim can be processed indicates that there is a warning indicates that there is an error or information missing the billing panel displays details about the claim selected in the claims list you can edit the claim details here, and select apply to record your changes, or revert to cancel them hot tip claim details not found in this panel can be viewed by clicking the detail button at the top right of the billing panel the disease coding assistant panel lists the disease codes previously used in the patient’s claims or medical record you can drag and drop these from the disease coding assistant to the icd 10 code field of the billing panel entering claim information the billing panel each claim’s details may be viewed by highlighting the claim in the billing view and reviewing its content in the billing panel below payer the payer of the claim this should be defaulted to medicare provider the provider for whom the service is being billed enter their profile code or name here service the service code associated with the service service description the service description will auto populate based on the service code entered above, but can be modified or added to if necessary qty/unit/unit% quantities, unit numbers and unit percentages may be modified here and will then auto calculate the claim value default medicare values will populate initially for the unit field history this checkbox will assign a history flag to the claim ic premium ic premiums that are available to be claimed electronically will appear in the drop down list profile will auto calculate the most profitable method of applying the ic premium to the claim, whether in units or by percentage icd 10 code an icd 10 code may be entered for the claim, but is not required diag /note diagnosis or additional note information required by medicare may be entered here referral the direction of the referral can be specified using the drop down menu in the field to the right of the drop down menu, a provider’s name or provider number may be typed directly into this field, or searched for by using the ellipsis button date/time if start and/or end times are required to be entered for a claim, they may be entered here location a location may be specified for the claim this will default to “1 office” site if required, a site may be entered by entering the site’s number, or by using the ellipsis button to select the site from a list on call this checkbox will assign an on call flag to the claim rotation a rotation code may be entered here, when applicable admission/ discharge/last admission date, discharge date or last billed date may be entered here role a role can be selected using the drop down list this will default to “0 general” vaccine lot if the patient was vaccinated during their visit (on the same date of service as the claim), the batch number(s) recorded by their provider will be available from the drop down menu toolbar actions the toolbar of the billing view provides the following actions add a new claim to the list without adding an appointment remove a claim from the list add a new invoice line to the selected claim check or uncheck the hold functionality for the selected claim create a private invoice from the selected claim when the private invoice is created, the electronic claim line will be removed open the details window for that claim refresh the view process all validated claims for electronic submission through medicare javascript%3ahhctrl textpopup(popup9105,%20'tahoma,8',10,10,10,10) viewing claims to view claims from the display transactions view, select on the main menu select the relevant patient from the select patient window that opens the display transactions view of the patient register will appear claims are viewed with their associated transactions unsent claims are also visible adding and altering medicare claim ranges to add or edit claim ranges for medicare in profile navigate to financial/medicare claim ranges and accounts from the main menu the medicare claim ranges and accounts window will open to add a new claim range, select the icon enter the claim range information as provided by medicare click ok to save changes and close the window to modify an existing claim range, double click its line in the medicare claim ranges and accounts window the window with the existing information will open make necessary edits and click ok to save changes and close the window invoicing a private patient follow this procedure to generate an invoice for a patient creating an invoice select the desired patient from the appointments view select the invoice button from the main menu the invoice window will appear hot tip for patients who are not in the appointments view, ensure that no one is selected in the appointments view and click the invoice button from the main menu then select the patient from the select patient for invoice window if the patient is paying for the service, make sure you have patient selected in the payer field at top left in the code column, enter the appropriate service code, or left click on to select one press the \[tab] key or click anywhere outside of the code column to update the billing line details select the button if payment is to be made right now, or if payment will be made at a later time hot tip before selecting , left click in theprintcheckbox to print an invoice for the payer the invoice window refer to the descriptions below for information on how the invoice window works the payer details panel is used to specify who is billed for the service the service details area shows details on each service that is being invoiced each service has a separate line on the invoice hot tip to view or edit a line, left click on the icon in the final column, or right click on the line and select detail… from the pop up menu the reference panel is used to link the invoice to such items as appointments, referrals, and approvals, when relevant the financial details panel is used to specify information about the rate being charged, and the provider and place of service (pos) from which the invoice is issued the commentary and message fields allow free format text comments to be entered the message text will appear on the printed invoice; the commentary text is for internal use only use the collect button to accumulate several delivered services into a single invoice tick the box marked check for interventions on invoicing for an option to complete any care plan interventions that are based on the services being invoiced tick the print checkbox to print the invoice clicking the pay now button will open the payment window for immediate processing of the payment the pay later button will file the invoice without payment either button will close the invoice window payer detailsservice detailsreference panelfinancial details commentary and message fieldspayment options payment at time of invoice if the invoice is to be paid now, follow these procedures using the “pay now” button if you selected after invoicing a private patient, the payment window appears verify that the value in the amount field reflects the actual amount of payment select a form of payment from the drop down list fill in the remaining fields, which will vary depending on the form of payment if you wish to print a receipt, place a tick in the print box if you wish to print the invoice with the receipt, also place a tick in the with invoice box click ok making a payment at any time if you selected after invoicing a private patient, you can record a payment at a later time using either of the two approaches outlined below making a payment from the appointment view to process a payment from the appointment view, use the following procedure select the patient in the appointment view and click on the main menu fill in the amount and the method of payment, as with the “pay now” procedure in the paid to field, enter the code of the person to whom the payment is made toggle the unmatched items panel by clicking on the button place a checkmark next to the invoice that the payment is to be allocated against do this by left clicking in the column click allocate, and then click ok making a payment from the transactions view to process a payment from the display transactions view, use the following procedure select on the main menu select the relevant patient from the select patient window that appears the transactions view will appear invoices are viewed along with their associated transactions select the transaction that is to be paid click the pay transaction button in the transactions view toolbar this will bring up the payment window enter the amount and method of payment and press ok hot tip the display transactionsdefault view shows only the transactions related to the patient you can change this to display third party transactions by clicking the button invoicing a third party follow these steps when invoicing a third party to invoice a third party or organization select the patient in the appointment view and click at the top left of the invoice window, select organisation from the drop down list in the payer field enter the name of the payer in the adjacent field either type the name directly into the field; or click the ellipsis button and select the organisation to invoice from the select organisation window place a tick in the print box select the button how to add a new third party organisation if you need to set up a new organisation as a third party payer, follow these steps go to financial/organisations on the main menu the organisations window will appear click to create a new organisation enter information about the organisation in the new organisation window you must enter the name of the organisation in the organisation field and enter a name or title in the name field of the contact information panel when done, click ok once the new organisation has been entered, it will be available as a payer whenever you select organisation in the payer field of the invoice window reconciliation reconciliation view the reconciliation view is broken down into five panels summary the summary panel displays totals and types of messages messages the messages panel is located to the right of the summary panel it contains messages from medicare reconciliations the middle area of the window is the reconciliations list selecting categories in the summary panel and/or selecting explanatory codes in the explanations tab of the details panel will affect what claims are seen in this area billing the bottom left panel is the billing panel, where claims in the reconciliations list can be modified for resubmission remittance the bottom right panel is the remittance panel this panel displays details of the selected claim summary panelmessages panel billing panelremittance panelreconciliation as an example, reconciliation of claims is usually done for the latest cycle, so selecting the default filter will show a breakdown of the pending claims from the last cycle in the summary panel with a claim selected in the reconciliation panel, corrections can be made in the billing panel below, and additional details for the claim are displayed in the remittance panel receiving the remittance to pick up the remittance click on the button on the toolbar the receive messages window will open click ok a progress bar will appear as profile connects and downloads the remittance reconciliation filter the reconciliation filter allows for narrowing down which message categories are seen in the summary panel, and thus which messages are seen in the reconciliations panel to create a new filter, click new at the bottom of the window to save changes to the existing filter, click update at the bottom of the window make sure to change the description to reflect the changes made the most common filter options are view description – name of the filter cycle – which remittance cycle(s) are seen; also can be thought of as the date range patient – show only messages for a patient when a patient’s name is entered provider – show all messages, messages for a selected group or only messages for one provider whose name is entered status – filter by status of message, whether it has been dealt with (complete, with one or more subcategories for the selected action) or not (pending) show columns – customize which columns are shown in the reconciliations panel in the screenshot, the default filter is shown note that cycle is set to latest, and status is set to pending this default filter will show all messages that need to be dealt with for the latest remittance cycle a similar filter could be made with a certain provider if it is preferred to work through one provider at a time accepting the gap for claims where the paid amount is different than the billed amount, a decision needs to be made whether to resubmit the claim or accept the difference, also known as the gap if the paid amount is higher than the billed amount, then the gap will be expressed as a negative dollar amount, to denote the overpayment screenshots showing the details of a claim before and after the gap is accepted note that while any claim is pending in the reconciliation screen it will show as outstanding until a decision is made financial reporting unlike remittance reports generated in the reconciliation window, the financial reports are generated and calculated by profile, which allows for many customizable parameters to present your financial data in a way that suits your workflow the most commonly used financial reports include revenue displays invoices and claims, i e income money that is asked for receivables displays outstanding money, i e unreconciled invoices or payments money that is owed to clinic payments displays income, i e revenue money that is received against a current or future service services displays the total amount invoiced or paid for each service code within a specified time period or transaction range sessions similar to the revenue report, except that it is based on date of service rather than date of transaction, which make it useful in cases such as determining how much to pay locums submissions displays claims processed in the billing view by submission date as an example, a private invoice is made for a third party organisation the amount of the invoice will show in the revenue report for that period, since it is for an invoice, and in the receivables report, since it is not yet paid when payment is entered into profile, the amount will show in the payments report, since it is now revenue report parameters for each financial report, there is an list of parameters that can be modified each time the report is run there is some difference between the reports but explained below are some of the common parameters date type typically a choice between transaction and creation transaction date is the date that the invoice or claim is dated for, whereas the creation date is the date that it is made in profile provider allows for filtering only financial transactions for one doctor, as opposed to the default all, which will show all transactions for all providers payer allows for filtering only transactions for a specific payer the default is all report allows for splitting into multiple reports, e g separate report for each provider first group and then group allows for sorting of data in the report sorting by payer is common so that third party and/or patient invoices will be grouped together include transaction detail if left unchecked, only summary totals will be shown if checked, each transaction will be shown in detail columns allows for customizing of the report by selecting which columns of data will be displayed service date is a common option that is not included by default financial corrections following some simple rules when correcting financial transactions you will eliminate most cases where accounts cannot be reconciled below are the few scenarios that account for the large majority of financial corrections, as well as common terminology common terminology credit journal a financial transaction used to adjust account balances where a patient's outstanding account balance is decreased debit journal a financial transaction used to adjust an account balance where a patient's outstanding account balance is increased write off a financial transaction used to remove patient debt by reducing the claim or putting a zero value on the claim write off – bad debt a financial transaction used to remove patient debt because the amount will be uncollectable to remove or otherwise cancel an unpaid invoice, write it off a credit journal will be made against the invoice (cjnlvi, or credit journal vs income) to remove or otherwise cancel a payment, refund it in the authorization window you will be presented with the option to a refund will be made against the payment if you also reverse the associated invoice, a credit note will be made against the invoice do not delete any financial transactions deleting financial transactions can cause problems with reporting and cause associated transactions to be un reconciled it is extremely rare that deleting a transaction is the best option find transactions the find transactions window allows you to search for transactions based on numerous criteria go to financial / find transactions on the menu bar the find transactions window appears enter the necessary criteria to search for the transactions click find the results will be displayed in the found transactions window find accounts and end of financial period viewing outstanding debts from control centre go to control centre/financial/find accounts use this view to monitor due and overdue accounts, and to print monthly statements the footer of the page list totals for item count, current debt, 30 day debt, 60 day debt, 90 day debt, total debt and bad debt the toolbar icons allow you to print statements for the selected patient or group send global letter to all or the selected group apply global journal to all or the selected group export the listed accounts end of month rolling over the end of month balances ages debtors balances, provider and organisation incomes, and payment balances complete all transactions to be included in the report print your reports and statements go to organisation/end of period/end of month the end of month window appears click in the appropriate checkboxes click ok the enter authorisation window appears enter the correct name and password click ok the end of month procedure is now complete you will now be able to start entering financial details for the current month printing transactions records statements select from the main toolbar menu select patient from select patient fordisplay transaction window this opens the alter patient/transactions view click enter in the required information and click ok transaction list select from the main toolbar menu select patient from select patient for display transaction window this opens the alter patient / transactions view click receipts select from the main toolbar menu select patient from select patient for display transaction window this opens the alter patient / transactions view select the transaction for which the receipt is being issued to print out more than one receipt at a time, select the desired transactions using the \[shift] or \[ctrl] keys click in the transactions view toolbar