HSA means ‘Health Savings Account’. When a patient has HSA account then HSA account can be used against particular visit of the patient. After receipt of Primary / Secondary EOB, when responsibility is with Patient, one more EOB (in paper / ELE) will be received from HSA. Although it is received as an Insurance EOB, it is treated like a Patient Receipt. When a HSA or HRA pays for Patient responsibility, they send EOB/ELE. Hence a provision is made to accept such HSA or HRA as Carrier on EOB/ERA screen which allow users to change ‘Paid As’ value from dropdown to ‘HSA’ only if patient has responsibility against that claim and when posted, it would affect the patient responsibility only and not insurance responsibility even if EOB is being posted.
Note: The option ‘HSA’ in field ‘Paid As’ Pri/Sec/Ter drop down at Claim level will be enabled only if there is patient responsibility against any charge line and users need to explicitly select this option from dropdown.
When a claim on EOB screen is marked as ‘HSA’ from ‘Paid As’ dropdown:
Salient features are listed below:
- Middle Frame: Dropdown ‘A2’ and button ‘I’ in middle frame on EOB screen are disabled.
- Middle Frame: ‘Recoup’ for ‘HSA’ payment is not allowed.
- Lower Frame: It might so happen that claim also contains other charge rows having responsibility associated to Pri/Sec Insurances other than charge row with patient responsibility. In such a case, all the fields for those charge rows having responsibility with Primary/Secondary insurances would be disabled. But all the fields having patient responsibility with ‘Paid As’ selected as ‘HSA’ for this charge row would be enabled except field ‘Paid’ amount.
- It is likely that while the ‘Paid As’ was ‘PRI’, user entered some Paid Amount and then changed it to ‘HSA’. Ins such a case Paid Amount although disabled is Not Zero. This error will be trapped when voucher is marked as Read to Post. The property ‘era.validate.conditions’ now has an additional Character ‘H’ supported for this HSA check.
- Lower Frame: When Primary/Secondary EOB is already received for claim and a new EOB is created for the same claim having patient responsibility against some charge rows, then all the charge rows displayed on EOB screen is marked as ‘Duplicate’ payment with highlighted with red background.
The red color for ‘Duplicate’ payment would be removed and Payment status would change from ‘Duplicate’ to ‘Normal’ as soon as ‘Paid As’ option is chosen as ‘HSA’ for charge rows having patient responsibility.
- Lower Frame: Button ‘Excess’, Button ‘Wo’, Status List Box, Button ‘Action’, checkbox ‘Bill Pat’ are disabled for HSA payment.
- Lower Frame: System will disable fields ‘CoIns’, ‘Copay’ , ‘Deduct’ and ‘NotCov’ amounts.
- Lower Frame: In case of charge row is selected where responsibility was with say Pri/Sec, not with patient even then ‘Paid’ Amount will be disabled.
- Patient Account Screen: Under remittance table on patient account screen, an entry is created for EOB received from ‘HSA’ account with prefix as ‘Hsa’ under column ‘Payor Name’ with Pri/Sec/Ter insurance.
- Reports >> Statement and Ledger: An entry for ‘HSA’ transaction is created and would show ERA number but would reduce the Patient Responsibility. Hence next to the Carrier Name, word HSA/HRA is printed for Patients to understand that it’s a ‘HAS’ payment which resulted in reduction of patient responsibility.
- Reports >> Summary: Predefined amount ‘212’ is added to display total of all HSA/HRA payments received through EOBs on summary reports with hyperlink.
- Reports >> Tabular: A Tabular report for ‘HSA/HRA’ payments received displaying patient name, DOS, HSA/HRA name, Amount Paid, etc. is incorporated . ‘HSA HRA Receipts’ tabular report is added to the system having code: ‘HSA01’ and classification code: ‘HSA HRA Receipts’.
Note: ‘HSA’ account is not applicable to Capitation Type Claims and Employer Billing claims.