| Manual Benefit Calculation
If you select Manual Benefit Calculation the Due Now amount will not increment as you post. It will stay unchanged during posting. After posting the charges, you may select the Due Now Adjustment option on the posting screen to manually increase the Due Now amount to whatever value you wish (as long as it is not larger than the Balance).
Before explaining this, let's discuss different methods of collecting the patient portion of the charges when the Manual Benefit Calculation is involved. The methods of doing this can vary widely and can be simple or complicated.
A simple method is to not consider any charges due by the patient until the insurance has paid what it is going to pay. After all the claims for this account have been paid by the insurance company, the patient (actually the responsible party) owes the remainder of the Balance. At that time, the Due Now amount can be increased to equal the total Balance, and the computer will then be expecting payment to be made.
The aging clock will start ticking at this point. If for instance, payment has not been received 30 days after the Due Now amount was increased to equal the total balance, the computer would consider that amount to be 30 days overdue. That is 30 days the computer has considered it to be due, even though the actual procedure and charge may have been completed much earlier.
Many offices prefer that the patient pay some or all of the patient portion as the treatment proceeds. This keeps cash flow up and reduces the necessity of sending the patient a large bill for treatment that was probably completed many weeks or months before. While in the posting screen you may directly modify the Due Now amount with the Due Now Adjustment option. With this option you may charge the patient his or her "patient portion." To determine what that patient portion is can be complicated or simple, depending on how involved you want to be with calculating the patient's insurance benefits.
Some offices may not want to be concerned with calculating benefits at all. They will merely enter some arbitrary amount for the Due Now Adjustment that they want the patient to pay that day. This is quite reasonable because anything below the total amount has to be considered a favor to the patient. The patient is actually responsible for all the charges that has been billed to his or her account. To set some arbitrary amount, you may charge the patient some percentage of the charges for that day, for instance 10, 20, or 50 per cent. You may even decide to charge the patient 100% of the charges for that day. This may in fact happen quite frequently. For example, you may be performing a procedure that the insurance will not cover.
When using Manual Benefit Calculation you must remember to perform a Due Now Adjustment after posting an insurance check. If you don’t, the Due Now will stay at zero, and the patient will never be billed. The Accounts Receivable Report has a special feature that can track down these accounts. The “Zero Due Now Tracker” option will list accounts with a positive Balance and a Zero Due Now that have not been billed or made a payment for X days. You supply the value of X. |