Author Topic: Patient ledgers  (Read 1460 times)

BSmith14

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Patient ledgers
« on: September 10, 2014, 03:02:16 PM »
When filling out a patient ledger would you post the copayment as a charge?  My instructor says only if they do not pay it at the time of service.  I do not see how that makes sense as the copayment does not have anything to do with the charges for service.  PLEASE HELP

Merry

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Re: Patient ledgers
« Reply #1 on: September 10, 2014, 03:09:54 PM »
Wow..a ledger!! Haven't seen one of those in years. If you were using a computer system of course this would not be an issue as the practice management systems are setup for this scenario.. If you are using a manual system, you would need to specify it as a copayment for that visit and post it as a charge and then zero it out if it were paid at the time of service. Of course the actual office charge would be posted separately and submitted to the insurance company. It is essential to keep track of every transaction. Is your instructor saying not to post it to the ledger at all if it is paid?

BSmith14

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Re: Patient ledgers
« Reply #2 on: September 10, 2014, 03:14:20 PM »
We are being taught paper in case the EMR crashes.  Thank you that is what i was trying to explain to her.  Would love to know why the school has an instructor teaching front office if they have never worked the front office
She is saying you post it as a payment if it is paid at TOS but not to post it as a charge unless they don't pay it.  It simply made no sense to me. 
If I have to I will do it her way in class and the right way in the real world.  She has the rest of the class doing it incorrectly.
« Last Edit: September 10, 2014, 04:18:05 PM by BSmith14 »

Merry

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Re: Patient ledgers
« Reply #3 on: September 10, 2014, 04:51:19 PM »
Perhaps you can teach the class some day. Good for you for being aware. It is an accounting issue..

BSmith14

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Re: Patient ledgers
« Reply #4 on: September 10, 2014, 04:57:32 PM »
Thank you for saying so.  It is just nice to know that I was right about my own abilities.

RichardP

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Re: Patient ledgers
« Reply #5 on: September 11, 2014, 10:57:34 AM »
BSmith - can we get a bit more complicated here?  I'm intrigued by the "know how to do it on paper in case the EMR is not available" angle.  To get to my question, let's see if we first agree on the basics:

First - Accounting 101 teaches the double-entry concept.  On the books, for every credit there must be a corresponding debit.  And for every debit, there must be a corresponding credit.  So that when you eventually total everything, everything totals to zero - debits and credits must equal each other.  Hopefully your instructor is not denying this fact.

Second - a copay is a co-payment, right?  Co-payment against what?  There has to be a charge - elsewise no payment is due.  So - the copay is a partial payment against some charge.  Since the payment is only partial, debits and credits don't have to equal each other at this point.  But there does need to be a charge against which the copay can eventually be applied.  Hopefully your instructor is not denying this fact.

We routinely get payments / copays for services rendered before we get the actual charges.  Our software has an "Unapplied" bucket in the ledger for each patient.  On those times where we receive the payment before we receive the charge, we post the payment to the Unapplied bucket.  When the charges come in and are posted, we apply the payments held in the Unapplied bucket to those charges.  I imagine any billing software worth anything has a simliar setup, although the name of the "holding" bucket might be different.

QUESTION:  Does the paper solution your teacher is getting you familiar with have something equivalent to the "Unapplied" bucket in my billing software?  That is, is there a special place to hold payments that have no corresponding charge until the charges come in?  Or are you just expected to write the payment in the patient's general ledger - and it will be out-of-balance until the corresponding charges come in?