Receipt Reconciliation Options

Once you have found receipts in a status of Error, what you need to do next is reconcile these receipts.   There could be many different options that you may take depending on why the receipt was set to a status of “Error”.    The various actions that can be taken are described below.

Action:  Hold Receipt

If you would like to place a receipt back into the “Hold” status, click the ‘Hold Receipt’ button.    If you want to set the hold date yourself, you must click ‘Hold Receipt’ in the upper right-hand corner of the screen.   If you want to hold the receipt based on an upcoming appointment date, you will click the ‘Hold Receipt’ button next to the appointment.  After that is done, the receipt’s status will be changed, and the hold date will be set accordingly.  Because the receipt is in this status, we will continue to attempt to turn this receipt into a payment using the receipt logic described above.

Use Case:  One reason for doing this is that you may know that for a receipt, you know that the claim may be added in the coming days/weeks.  So, you put the receipt back on hold for that day or a few days later so that the receipt will be automatically reconciled once that claim gets generated.

 


Action:   Reverse Receipt

If you determine that a receipt was added by mistake, the receipt can be reversed.  To do this, click the ‘Reverse Receipt’ button. After doing this, any payments that resulted from this receipt will be reversed.   Also, a negative receipt will be added with the exact same amount as the receipt selected – this allows reports to balance correctly.

Also, if this receipt had been generated from a Credit Card payment, you will be prompted to refund the credit card as well.  You may or may not want to issue the refund directly to the credit card – this is up to you to determine how the money will be returned to the patient.

Use Case:  A duplicate payment was made and one needs to be reversed.  

Action:  Edit Receipt

When reviewing a receipt, you may realize that the information was captured incorrectly, or a patient/guarantor was not assigned correctly.  You can fix some of these details by clicking ‘Edit Receipt.  This will provide you with a window to link the receipt to a patient (if one was not already linked), change the Payment Type and Payment Method.

Action:   Create Claim

As a reminder, receipts must be applied to claims.  If no claim exists, it may be necessary to create a claim to then link the payment to.   When you click ‘Create Claim’ button, a new claim will be created using the following details from the receipt or the appointment.  If you want the receipt details to be used, you must click ‘Create Claim’ in the upper right-hand corner of the screen.  If you want the appointment details to be used, you must click ‘Create Claim’ next to the appointment.

  1. Patient and Insurance Details
  2. Receipt Date or Appointment Date -> Claim Service Date
  3. Receipt Location or Appointment Location - > Claim Service Location
  4. Appointment Resource -> Rendering Provider

You will be able to set the following details as well:

  1. Provider -> Rendering Provider
  2. Procedure Code (you can add one procedure code, more can be added later)

Once the claim is created, the claim window will then be opened, and you can make any changes as you see fit.

Now, it is important to know, the receipt is not automatically applied to this claim.    You have one of two options once you have created the claim.

Option 1:  With the Claim window open, you can launch the ‘Edit Payments’ window.  From here, the receipt can be posted as a payment to this claim.

Option 2:  You can click the ‘Reconcile Receipt’ button.   This will force the system to immediately run the Receipt Reconciliation process.

Option 3:  You can set the Hold date for the claim so that the Receipt Reconciliation process will link the receipt to the claim automatically overnight.


Action:   Communication

If you have reviewed a receipt and you need more information from a staff member, a common action to take would be to send an office communication to a staff member asking for the necessary details.  To do this, click the ‘Communication’ button.  This will open a new office communication window with the patient’s chart automatically attached.  

Please note, the receipt has not been reconciled at this point. You may need to take one of the other actions later once you receive the information from your team.