Billing Release Notes September 20, 2018

1. Start by creating a Contract Rate and populating the contractual allowed amount for the insurance company.
2. Approve an encounter that pulls the contractual allowed amount for the payer and submit the claim.

Run Reports

1. Reports > Payments > Contract Management Detail. The Contract Management Detail report opens.
   • The report will display the new columns below:
     • Exp Allowed: The payer’s Contract Rate amount set in Contracts and Fees > Contract Rates.
     • Total Exp Allowed: The Expected Allowed amount times the Units.
     • Actual Allowed: The Allowed Amount posted in the insurance payment.
     • Diff: The Total Expected Allowed amount minus the Actual Allowed amount.
     • % Diff: The Difference divided by the Total Expected Allowed amount.

2. Reports > Productivity & Analysis > Account Activity. The Account Activity report opens.
   • The report will display the new columns below:
     • Unit Charges: The charge per Units.
     • Total Charges: The Units times Unit Charges.
     • Exp Allowed: The payer’s Contract Rate amount set in Contracts and Fees > Contract Rates.
     • Total Exp Allowed: The Expected Allowed amount times the Units.
     • Total Payments: Total Payments includes payment from primary insurance, secondary insurance and patients.
   • To see payments by insurance company or plan, click Customize. Then select Insurance Company or Insurance Plan in the Group By drop-down. Click Ok.

Payment Posting

When posting a new or editing an insurance payment, the Expected Allowed will be populated from the payer’s Contract Rate amount set in Contracts and Fees > Contract Rates.

Patient Account Tab

The Patient Account tab also populate the Expected Allowed from the payer’s Contract Rate amount set in Contracts and Fees > Contract Rates.