Patient Register
Adding a new Entry to the Patient Register
To record patient payments, insurance payments, insurance adjustment, or physician adjustments, select a Patient, then click the Register tab.
The Show All button (in the lower left corner of the screen), when checked, will show all activity for the selected patient. If Show All is unchecked, then only the un-cleared claims will be shown in the patient register.
To record a payment or adjustment, select the charge using your mouse, then right click or press the Enter key.
Insurance Payment and Adjustment
For each charge line, MDC allows you to record the payer adjustment and the payer payment at the same time.
The payment entry screen will show each line of the claim. Enter the amount that was allowed for each charge on the claim along with the payment that was made. Some payers show an actual adjusted amount rather than an amount allowed. To enter the adjustment as an actual adjustment, click the ALLOWED (+) label. The label changes to ADJUSTED (-). Now you can enter the actual adjusted amount. For example, on a $20 charge, if the payer allowed $14, you would enter $14 if the label is ALLOWED (+). If the label is changed to ADJUSTED (-), then you would enter -6.00. After the adjustment is recorded, the patient register will always show the adjusted amount (-6.00).
Enter the entry date, payment method, and check number (if applicable). You can also enter a check date. By default, the check date is set to the entry date. If the check date field is not visible on your system, and you wish to enter a separate check date, you need to enable the check date field using the Preferences screen.
Always use the tab key to progress though the payments and adjustments screen. The cursor will move logically from one field to the next. When recording an adjustment and a payment, the payment field will automatically receive the result of the amount allowed times the percent covered.
Payment = Allowed * %covered
If you are not showing the percent covered field, then 100% is assumed the first time the cursor is moved to each payment field. On each re-entry of the cursor into the payment field, the payment field is unchanged from the previous amount.
To show or not show the percent covered field, see the Preferences screen.
You can also record insurance payments and adjustments from the Payer Register.
Primary and Secondary Payers
If the patient has secondary, then the claim responsibility can be changed to the secondary payer after the primary makes a payment or adjustment on the claim. When you post a primary payment (or adjustment) to a line item of a claim and the claim was created with a secondary payer, then the following prompt will appear:
MDC will check if payments/adjustments have been applied to all the line items of the claim. If each line item has at least one payment/adjustment, then the prompt will suggest that the claim responsibility is changed to secondary. When you click OK to this screen, the claim will no longer be the responsibility of the primary payer and the claim will now appear in the secondary payers register. You also have the option to have this claim put back into the print queue so that it can be re-printed for the secondary payer.
If at least one item has not received a primary payment or adjustment, then the prompt will still appear but the ‘Send claim to secondary payer’ check box will be un-checked.
When you click OK to this prompt, the claim will remain the responsibility of the primary payer. The claim will still exist in the primary payers register. You can manually control this as each primary payment is made.
If afterward you need to check which payer is responsible for the claim, you’ll need to go to the particular claim and see what payer has the ‘Send Claim Form’ button checked.
Insurance Payment
Use this to record only an Insurance Payment. This separate selection for the Insurance Payment is provided only for convenience and simplicity. You can use the previous screen to do the same thing if you do not enter an adjustment or if you leave the allowed amount the same as the charged amount.
Insurance Adjustment
When you select an Insurance Adjustment, the same screen as above is displayed but the Payment fields are disabled. Use this screen if you’re only going to record an insurance adjustment. This separate selection for the Insurance Adjustment is provided only for convenience and simplicity. You can use the previous screen to do the same thing if you leave the payment amount blank.
How to record a non payment
To record an insurance non-payment or to mark a charge so that it’s been responded to by insurance, you need to record an insurance payment using a dollar amount of $0.00. Be sure to include a memo. MDC will always default the Memo to include the payer name as long as an amount is entered in the payment field. For non payments, the amount entered will be $0.00 so the default memo will not be inserted. If you attempt to record the payment when the amount is $0.00 and there is no memo shown, then no payment will be recorded. If you include a memo, then MDC will create a $0.00 payment with the memo you supply.
Marking a Claim as ‘Responded’
As soon as an Insurance payment or adjustment is applied to an item of a claim, the claim is automatically marked with an ‘R’ indicating that the claim has been responded to by the payer. In cases where the patient has Secondary insurance, the claim will not be marked Responded until both Primary and Secondary have had a payment or adjustment applied. You can view the Responded flag by exposing the far right column of the patient register. Use your mouse and drag the far right column to the right.
MDC provides a method of forcing the Response flag on or off. To enable this functionality, see the File Menu – Practice Information – Defaults. With the response forcing enabled, you can select a charge line and Manually force the response by selecting ‘Force Response/Aging Date’
To force the response, click the Force Response button then select the Primary Response and/or Secondary Response. When the response flag of a claim is forced, the Patient register will indicate ‘RF’ instead of ‘R’. The F indicates the claim response is Forced on.
The Response column of the Patient register can contain the following items:
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The importance of the Response flag is that it is used to determine who is responsible for payment of the claim. Initially when a claim is filed the patient is not responsible for the claim balance and the claim amounts will not show on the Patient Statement nor will the amounts be included in the Patient Aging. As soon as the claim is marked ‘Responded’, the claim balance becomes the patients’ responsibility. Similarly, the Payer balance will not include the claim charges after the claim is flagged as ‘Responded’.
A claim will automatically be marked Responded if the claim balance is $0.00. At the same time, the claim is marked as Cleared and will no longer appear in the patient register (unless Show All is checked).
If you want to make the Patient Responsible for a claim regardless of the payer response, see File – Practice Information – Defaults. Uncheck the option to wait for payer response before the patient is made responsible.
Physicians Adjustment
A physician adjustment should be used if the physician or practice wishes to adjust the balance of a claim or charge.
Send to Collections
This is the same as a Physicians adjustment except that the patients’ account is mark as delinquent.
Patient Payment
Use this selection to record a patient payment. Patient payments can be applied to individual line items or they can be applied as a lump sum payment. When Patient payment is selected the screen looks and acts the same as the Insurance Payment screen but has an additional option to apply the payment as a blanket payment across multiple charges.
To apply a blanket payment, click the Blanket Payment button.
Enter the total amount of the payment. MDC will distribute the payment towards open items in the patient register. The first item that receives a payment will be the item that is selected when Patient Payment is selected from the popup menu.
Check Number Field
Use the check number field to help identify lump sum payments. MDC will lump payments into one line in the transaction report and the patient statement if a common check number is found for the same date. So to keep payments organized, use the check number field, even if it’s a cash payment. Adding a unique reference will help identify payments when they are distributed among multiple charges.
Comment
Use this selection to post a comment or message to the patients’ account. The message will appear on the patients’ statement.
Patient Pre-Payment
If you need to apply a payment to a patients’ account, but the payment cannot be applied to a particular claim, then post a Pre-payment. Pre-payments can be applied to charges at a later time. When you apply a pre-payment the payment will appear in the patient register as an unapplied payment.
Applying an Unapplied Payment
If the patient has unapplied payments, you can apply these payments to existing charges in the patient register. Select a charge line then select Apply an Unapplied payment from the popup menu or press F8.
Select the unapplied payments by clicking the Number column then click the OK button.
Issue a Credit
To issue a credit, the patient register must have unapplied payments. Rather than applying the unapplied payments to an existing charge, you can create a Credit Transaction to offset the unapplied payment. You can then print a credit memo for the patient or the payer. Select one of the unapplied payments then click the Issue Credit button.
Place a check mark next to the unapplied payments that you want to credit. Click the Credit Memo to be printed button prior to clicking OK if you will be printing a Credit Memo for this transaction. The Credit Memo will be placed in the Invoices to be printed list.
After you’ve created the Credit Memo, if you forget to mark it for printing, you can edit the credit memo and re-mark it for printing.
Modifying a Payment or Adjustment
To modify a payment, adjustment, or comment select the item you want to modify, then press the Enter key and select Edit from the pop up window.
When modifying a payer payment or adjustment make the necessary changes then click the OK button.
If you change the check number, check date, or memo, any other payments that have been recorded using this payer and this check number will be updated to reflect the changes. For example, suppose you’ve applied a payer payment and the payment was applied to multiple charges. If after recording the payment, you realized that the check number was incorrect, you only need to update one of the payments with the new check number. The other payment check numbers will be updated automatically.
Last Update: 10/15/2008