Another reason for running reports is to troubleshoot the amounts that are being billed on Remainder Statements and the amounts shown on Insurance Aging reports. The report most often used for this process is the Billing and Payment Status report.
Remainder
When troubleshooting remainder balances, it is imperative that you look at individual charges. Each charge with a balance is represented by a line item on the Billing/Payment Status Report. The columns you want to focus on when troubleshooting remainder balances are the Policy 1, Policy 2, Policy 3, and Balance columns.
In order for a charge to appear on a remainder statement, each of the Policy columns MUST have an asterisk (*) next to an amount. That amount may be zero. The asterisk indicates that a payment has been entered for that carrier and that payment has been marked complete. It can also mean that the specified carrier is not responsible for that charge.
If any of these columns do not have an asterisk that charge balance will not be included in the remainder balance and on remainder statements. If you expect a particular charge to appear on a remainder statement, and it doesn’t have an asterisk, you must either mark the existing payment complete, or enter a new payment for that carrier and mark it complete.
The only exception to this rule is when the Accept Assignment field in the patient case screen is not checked. See the Accept Assignment Handout for more information.
The other critical field is the Balance column. If there is not a balance on the charge, it will not be included on a remainder statement.
Aging
When troubleshooting aging reports, you will need to have the same focus on individual charges that you had when troubleshooting remainder balances. Additionally, you will want to look at the same columns: Policy 1, Policy 2, Policy 3, and Balance. Additionally, you may need to look at the Guarantor column.
A charge will not appear on an insurance aging report if one of two conditions exists.
- The insurance carrier in question has not been billed for the charge in question. If this is the case, the Billing and Payment Status report will display the value Not Billed in the correlating Policy column. If the charge has been billed to the insurance carrier, a date will appear signifying when the charge was billed on a claim. Additionally, it is important to note that insurance aging will ALWAYS be based on the date the claim was sent, NOT the date of service.
- If the insurance carrier has already paid for or is not responsible for a charge, it will not appear on the insurance aging report. Either of these conditions will be shown by an asterisk in the corresponding Policy column.
It is possible to age a patient remainder balance by either Date of Service (Transaction Date From), or by Date of First Statement. If you are aging by the Date of First Statement, the aging process will not begin until the patient is sent a statement. Therefore, a charge showing Not Billed in the Guarantor column would not appear on the Patient Remainder Aging report.
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