Topics Statement Search:  
Introduction

The Clinic needs to send a statement of charges and payments received to the Patient/Responsible Person on a periodic basis like Credit Card Statements. The information in Billing is large and could become many a times confusing for the Patient to read and interpret, especially in the context of Insurance.
As such there are two format provided by default (the layout and details within each can be further configured by the user). The first format considers only Patient Bills. There are four types of Bills raised on a Patient.

P1 - Charges Directly Billed to Patient for a visit
P2 - Charges Billed as Patient Responsibility depending on the Remittance from Primary Insurance
P3 - Charges Billed as Patient Responsibility depending on the Remittance from Secondary Insurance
P4 - Supplementary Finance Charges Billed to Patient.
Only these Bills and amounts received from Patient against these Bills are included in this statement.

The second format includes details of all charges billed to Insurance as well as Patient. The amounts received / adjusted / Write Off from Insurance are also printed in the statement, besides the amounts received from Patient. No doubt this is a lot more comprehensive, but could become overwhelming, as such not preferred by all.

The pop up 'Statement' window as such provides the options to select one of the two formats 'Claim wise' and 'Charge code wise' for a Patient or A Responsible Person.

Statement Generation

Send statements

  • Patient
  • A Responsible Person - For choosen 'Responsible Person', single consolidated statement is generated having individual statements of patients associated to the 'Responsible Person'.
  • An Attorney - Radio button ‘An Attorney’ is provided to generate the statement. A consolidated statement is generated. This consolidated statement contains individual statement of patients who are associated to choosen ‘Attorney’. It is the quickest way to find out about patient related transactions under Attorney. There are two statement formats using which statement can be generated:
    1. Claim wise
    2. Charge code wise

    ‘Claims wise’ statement format supports ‘Attorney Statement_type2’ whereas ‘Charge Code wise’ supports ‘Attorney Statement_type3’.

For Specific Patient or Responsible Person/Attorney, either use search button or autocomplete feature, select the required Responsible Person/Attorney/ Patient. Multiple selection of Patient/Responsible Person/Attorney is allowed.

Note: Statement for 'A Responsible Person' can be generated for charge code wise option only according to PrognoCIS workflow. When option 'A Responsible Person' is chosen, option for statement format is by default selected as 'Charge Code wise' and option 'Claim wise' is grayed out. The Template 'Resp. person statement type 3 - STRIB3' is displayed in drop down 'Template' to print the statement for 'A Responsible Person'.

 

Statement Date From

Field 'Statement Date From' accepts the date in mm-dd-yyyy format. Date entered in this field is treated as cycle start date. The statement having transactions between the date entered to current date is printed having opening balance as on date entered and transactions within the stipulated date range entered or opening balance with transactions related to opening balance as on date entered and transactions within the stipulated date range entered. Option to print only opening balance in a single line or opening balance with detailed transactions depends up on selection of option 'Print Ope Bal' / 'Ope Claim Details'.

Min. Outstanding Amount: Amount Due less than specified value. This is to ensure that letters for outstanding of less than specified amount are not generated.

Statement Format

There are two types of statement formats. These are

  1. Claim wise - Letters for outstanding will print claims wise details.
  2. Charge Code wise - Letters for outstanding will print charge code wise details.
    • Claim wise
      Statement Format 'Claim wise' provides capability to print letter of outstanding depending up on selection of radio buttons under 'Claim wise' option. Default selection of radio button 'Print Ope Bal' / 'Ope Claim Details' is dependent on property 'statement2.donotuse.opening.balance'. When this property is set to N then radio button 'Print ope Bal' otherwise radio button 'Ope Claims details' will be always selected by default.

    Print Ope Bal: With this radio button selected, single line with opening balance amount is displayed on patient statement.
    Ope Claims details:With this radio button selected, detailed transactions related to Opening Balance are displayed on patient statement.

    Hide Diagnosis Code: When checkbox 'Hide Diagnosis Code' is marked, the details about diagnosis codes are not displayed on the statement.

    Hide Fully Balanced Claims: When checkbox 'Hide Fully Balanced Claims' is marked, the details about fully balanced claims are not displayed on the statement.

    Hide Charge Description: When checkbox 'Hide Charge Description' is marked, the details about charge description are not displayed on the statement.


    Template: For 'Claim wise' statement format , drop down displays template having subtype set to STPIB2 and name starting with 'patient'. The templates can be configured from settings>>configuration>>Templates>>Billing. Design the template for sub type 'STPIB2' and save the template. The Template name should start with 'patient and save it. On Statement pop up, all the templates for 'Claim wise' statement format having sub type as 'STPIB2' and name starting with 'patient' will be displayed in the drop down 'Template'.

    • Charge code wise
      Statement Format 'Charge code wise' prints letter of outstanding with charge code wise details.

    Hide Diagnosis Code: When checkbox 'Hide Diagnosis Code' is marked, the details about diagnosis codes are not displayed on the statement.

    Hide charges with zero patient balance: When checkbox 'Hide charges with zero patient balance' is marked,charge codes with zero patient balance are not displayed.

    Template: For 'Charge code wise' statement format, drop down displays template having subtype set to STPIB3 and name starting with 'patient'. The templates can be configured from settings>>configuration>>Templates>>Billing. Design the template for sub type 'STPIB3' and save the template. The Template name should start with 'patient and save it. On Statement pop up, all the templates for 'Charge code wise' statement format having sub type as 'STPIB3' and name starting with 'patient' will be displayed in the drop down 'Template'.

    Note: Patient Statement prints prefix like ‘Pri/Sec/Ter’ from 'Paid As' field on EOB screen along with the name of Primary/Secondary or Tertiary insurance accordingly and appropriately. Therefore, Patient Statement provides complete information about Patient details in terms of ERA received.

Message: Enter message that you wish to print in order to notify a patient/ responsible person through statement.

Add to Patient Account-Statement, on Print: When it is checked, an entry is created on Patient Account under Statement table with details about generated ststement.

Dunning Msg: Dunning messages are those messages which are picked up from pop up 'Dunning Messgae' which is invoked when button 'Dunning Msg' is clicked. Dunning message is printed for maximum outstanding amount of the aging bucket. It is customizable using pop up and is printed on the statement at the end.

Note: While designing this templates (under Settings > Configuration > Billing) ensure that following sections / keywords are present in specified order.
_PATIENT_HEAD_
_VISIT_DETAILS_
_TRANSACTION_HEAD_
_CHARGE_START_
_CHARGE_END_
_RECEIPT_START_
_RECEIPT_END_
_PATIENT_END_
_FOOTER_