In this video, I'm going to walk through some example charges and payments to show how billing functions are handled in the MD HQ EMR.
Let's start off by adding some charges to this open note. There are a few ways to get to the charge search bar to add a charge. The most straightforward way is to click on the plus icon in the Charges box and type to search. In this example, for the flu vaccine. In the Add Charge popup that appears, I can edit the charge amount, designate whether it should appear on an insurance invoice, and add or edit a CPT code or CPT modifiers. This all looks good, so I'll just add it to the note.
Another way to add a charge is to type in the Quick Add prefix for charges "ch" in the main text block followed by an underscore and search terms – in this case "office" "05" for a five minute office visit – find the charge in the suggestions list, and then click to add the charge. A third way that I won't show here would be to use a Chart Part template that contains the charge you're looking for.
Now let's save the note and take a look at payments.
THE BILLING BLOCK AND BILLING HISTORY POP-OUT
The Billing block on the patient's dashboard page shows the patient's account balance and lists charges and payments in reverse-chronological order. Charges are generally listed by encounter note and date of service. Payments, as well as charges that were added outside of an encounter note are listed by the date they were added. Hovering the mouse cursor over an entry shows more information. Or you can pop-out the Billing History to view details and manage billing.
By default the billing history is sorted by Date of Service, but can be resorted by any column simply by clicking on the column name. You can check multiple transactions to add them to an insurance invoice or create a printable receipt. Or use the right-hand column to indicate which transactions have been reviewed for internal administrative and accounting purposes. From the billing history, you can also view or edit the patient's billing details, generate an account statement, add new charges, or add or allocate payments and credits.
I'm going to go ahead and re-sort by date of service and then add a payment. You'll notice that the Apply Credit button is not available because Hera does not have unallocated credits in her account.
If Hera was ready to pay her balance in full, I could check the box under payment amount to have the system automatically enter the total amount due and fully allocate the payment to all unpaid charges. But let's say that Hera can only pay $100 today. I'd start by entering the payment amount, and then designating which unpaid charges to apply it against. I could pay off this first note entirely and apply the rest of the payment against the second note, leaving $25 remaining balance on that note. Or, I can go in and edit how much is applied against each charge, for example making a $20 payment against these first three. Notice that payments in excess of unpaid charges or payments that are added but not fully allocated to unpaid charges will become available or unallocated credits that can be used to pay future charges to the patient's account. This is true even if the patient's overall account balance is negative. For example, if I added the payment now without fully allocating it to these charges, Hera's account would have $40 worth of credits and $423 remaining in unpaid charges.
I'm going to change the payment amount so that Hera can pay for last year's flu vaccine as well as this big annual exam charge. The payment method will be by check. Now, you can see the new payment at the top of the billing history, and these two old encounter notes are marked as paid. One other cool thing that you can do here: if you just want to pay a single encounter note, you can click on the balance in the left hand column. The system automatically enters the payment amount and allocates payment to the selected note. And our flu vaccine note is now paid in full.
Now that we've made several charges and payments to Hera's account, we'll generate an account statement to provide a billing snapshot and to see exactly where the remaining $100 balance comes from. As with all of our printable, most every field is editable. You can also change the date range using the date selector at the top of the page and clicking Show this Date Range. Print, fax, or save the statement to the patient's account to help you get paid and keep track of billing.