View Patient Billables

The Patient Billables section of the patient's profile provides an overview of the individual billables created to account for patient responsibility.

User Permissions

Managing Organization Admins and Organization Admins can view and edit billables without additional permissions. However, profiles with User-level designations require additional permission configuration by an admin before this tab can be accessed. For more information on Patient Billing permissions, click here.

Patient Billables Overview

To view any new or existing Patient Billables, navigate to the Patient > Patient Billing > Patient Billables section of the system. This section offers users four different filters to search for and refine the information found within each billable, as well as three distinct features to make managing patient billables a breeze. 

Available Filters and Features

• The Status filter provides users with five options to refine the billables displayed in this section.
  

  

  • All: Using this status will instruct the system to display all billables, regardless of their current status.
  • Approved: This is the default status and displays all billables that have been approved and are currently, or have been, actively worked.
  • Created: This status indicates that a billable stemming from private-pay services has been made in the Work Center, but the final version has not yet been approved.  
  • Processing: When a large number of billables are created or approved simultaneously, the system may take longer to update their status. This filter allows users to view billables whose status is currently in transition but has not yet been completed.
  • Voided: This status indicates any billables that have been voided since their approval.
• The Show filter is used to refine results based on the current A/R status of the billable item. The system defaults to displaying all billables, regardless of balance, but these results can be refined by selecting Open Balance Only.
• The Source filter indicates the origin of the charges and provides three options to refine the patient billables displayed.

  

  • All: The system will default to displaying all billables, regardless of their origin.
  • Claim: This option will display approved billables that were created as a result of a closed insurance claim.
  • Private Pay: This option instructs the system to display billables that were created and approved as a result of private-pay services rendered.
• The View Columns filter is used to refine the amount of information displayed for each billable. Each column name displayed in the dropdown can be removed from the view by unclicking the checkmark next to the column name.

  

  Name	Definition
  Control Number	This is the Patient Billable claim number. e.g. AV-DTRL-PXXXXXXX.
  Created Date	This is the date the billable was first created.
  Status	This indicates the current phase of the billable. A billable has four potential statuses: Approved, Created, Processing, and Voided.
  Source	This column identifies the source of information for the billable. If the source is an Insurance Claim, the claim number will be embedded within this column.
  DOS Start and DOS End	These columns indicate the first Date of Service and the last Date of Service of the billable.
  Service	This is name of the rendered Service(s.)
  Units	This is the number of times the service was rendered.
  Total Charge	This is the total patient responsibility for services rendered under a closed insurance claim or private pay.
  Ins Paid (Facility)	This column will display the amount paid directly to the facility.
  Ins Discount	This column will display the sum of all CO-45 adjustments applied to the source claim/payment.
  Ins Adjusted	This column will display the sum of all CO (except 45), CR, PI, and OA-100>  adjustment codes.
  Deductible, Co-Ins, and Co-Pay	This column will display the sum of the deductible, Co-Ins, and Co-Pay.
  Additional PR	This column will display the sum of any PR and OA-100< adjustment codes.
  Ins Paid (Patient)	This column will display the sum of any PR-100 and OA-100< adjustment codes that indicate the patient/subscriber was paid directly.
  Provider Adjusted	This column will display any financial adjustments applied to the billable.
  Patient Paid	This column will display the sum of all payments made by the Patient that have been applied to the billable.
  Patient Amount Due	This column displays the remaining balance (Charges - Adjustment + Patient Payments) for the Patient Billable.
  Balance Status	This column indicates the current balance's state and whether additional review is needed. Billables with an Out of Balance status are an indication that the final insurance payment has been altered or does not match the original claim.

• You can download the Patient Billables tab by clicking the Download to Excel button, which automatically generates and downloads a spreadsheet for review.

Manage Patient Billables

This section provides users with multiple options to manage patient billables successfully. Let's review the available workflows.

• Clicking Adjust will allow the user to reduce the billable balance by applying an adjustment reason. For more information on applying adjustments, click here.
  
• The Close button will close the individual billable when clicked.
  
• Clicking Close All Billables will close all open billables, regardless of their balance.
• The Bulk Close Billables button enables users to select and close any open individual billables with a single click.

Helpful Hints

Let's review some helpful hints together!

• Approved Patient Billables can be reviewed in bulk by navigating to the Record Center > Patient Billing > Patient Billables section of the RCM. For more information on the Record Center, click here.
• When a patient's balance is $0, the billable will automatically close.