Client Ledger Best Practices

Access Client Ledger
Enter Manual Payment
Refund a Payment
Troubleshoot Ledger Errors – Steps
Common Ledger Issues
Filter by Date

 

Access Client Ledger  

1. Select Billing under Client/Employee/Doctor dropdown.
2. Select Client Ledger under Select a Transaction.
   
   
3. Select a client from the drop down.
   • Selecting the Filter by date check box allows you to search a specific date range.
4. You will see 3 separate tables.
   • Outstanding Billing Items
   • Payment History
   • Historical Billing items
     
     

Enter Manual Payment

1. Run the report.
2. Select items for which to apply payment.
   • If no items are selected, the amount paid will apply to the total amount due starting with the oldest billing items first.
     
     
3. Click Enter New Payment.
4. Select the payment method.
   
   
   
   • If you applied a check, select the check Payment method and enter the check number, amount and Payer Name.
     
     
     
     
5. Complete the form and click Save.
6. After a payment is entered:
   • The Total Amount Due will reflect the payment; Over payments will be relfected as a credit and the total amount due will be green.
   • Any outstanding billing items that were paid will be removed from the Outstanding Billing Items table.
     • Avoid updating claims manually to received as they will appear in the Historical Billing Items with an outstanding amount as opposed to being paid.
     • A claim that has been paid in full in ledger will be marked as Received in the submission report and will appear in your Historical Billing Items.
     • A claim is considered paid in full if the Adjustment + Total Paid = Total Billable amountThe payment will be reflected in the Payment History table.
   • The payment will be reflected in the Payment History table.
     • The claim’s Patient Applied field will update with the payment made from ledger.
     • The Total Paid field will update and add the payment made from ledger to any pre-existing payments and display total.
     • It is advisable not to edit claim fields such as the Co-Pay, Co-Insurance, and Deductible unless there is communication with insurance on an update to the client’s Patient Responsibility.

Refund a payment

Option 1

1. Run the report.
2. Click Manual Refund at the top of the page.
3. Fill out the form with the refund information.
   1. If you do not know your Ledger Pin, please reach out to your account manager.

Option 2

1.  From the Payment History Table, find the specific payment you would like to refund.
2. Click the Refund button.
   
3. Complete the Refund form, add a refund description for your records.

Note: please do not use Stripe dashboard to refund payments.  Refunds should be done via ledger.

Troubleshoot Ledger Errors – Steps

1. Go to Client Ledger.
2. Copy and take note of Item Ids for claims that appear incorrect in Outstanding or Historical Items sections.
3. Go to Submission Report.
4. Select Search by Item ID.
   
   
   
   
5. Click title of claim.
   
   
   
6. Click Version History
   • Review history of claim for any manual edits made to claims.
     
     
7. See below for common ledger issues that can affect ledger.
8. Make claim corrections -  click title of claim and click edit item.
   
   
   
9. Click Save on claim information window.
10. Claim should update correctly on ledger.

Common Ledger Issues

1. Manually updating claim to Received billing status causing ledger to display an outstanding amount in historical items.
   • This is an example of a user/staff member updating a claim to received status.  The version history below shows the update.
     
     

• This will cause the issue below in the ledger’s historical billing items.
  

Items should not be manually set to Received status to avoid this issue.  The ledger will automatically put an item into received once the Adjustment + Total Paid = Total Billable amount.

Solution

To undo this issue, please use the version history restore option to restore to the previous version.

• This will pull the claim back into the Outstanding Billing Items table.

2. Manually posting payment to submission report and updating claim status to Patient Responsibility.
   • Follow the steps to trouble shoot. The version history is used to determine if a manual edit has been made.  
   • A staff/user’s name will appear to the right of each version. Below each version a list of fields updated by the user on the claim displays.
     
     
   • In the claim below, a payment was manually posted via submission report rather than the client ledger. 
   • This was done by editing the claim’s Total Dollars Paid using the submission report’s inline edit capability; the user clicked into the Total Paid column for this claim which posted the payment manually.
     
     

Patient Responsibility payments should be made via ledger, and Insurance payments should be made via the Post Payments/Payment Report option on the dashboard. 

Solution

If communication between insurance was made and verified the claim was processed and had an outstanding patient responsibility (Deductible as an example), you will need to do the following:

1. Select Billing and Post Payments on the dashboard. The Payment Report opens. 
   
2. Enter Item ID and click Update View.
   
   
   
   
3. Enter Payment information by entering in a check amount, entering insurance name for Payer, check number, and check deposit date.
   
   
   
   
4. Click the Patient Responsibility button to enter Patient Responsibility information.
   A new window will appear.
   • Update the Co-Pay, Co-Insurance, or Deductible accordingly based off communication with insurance.
   • Click Save Changes.
     

     Note: A claim will not display in ledger if the Co-pay, Co-Insurance, or Deductible are empty.

   • The Patient Responsibility Outstanding in the ledger is calculated from the sum of the Co-Pay, Co-Insurance, and Deductible.  These fields should NOT be edited unless you must correct claim due to an issue with electronic submission and obtain accurate information from the insurance.
     
     
     
     
     
5. Finalize Insurance payment by clicking on Apply Changes
   
   
   
   
   •  Use the fields at the top of the page to apply payments to more than one claim.
     
     
     
   • A payer name, check number and check deposit date should always be entered. 
   • If you wish to disperse payments equally, the check amount field may be used and the amount will be dispersed to the oldest outstanding claims first.  Otherwise, you may post payment directly into each line item manually if you wish to make specific payments on the claims.

Filter by Date

1. Check the Filter by Date checkbox to filter the view by the  billing Items. The payments are not filtered.
   • This filter is meant to be used to find specific claims . The ledger balance is broken when filtered.
     
      
2. Remove the Filter by Date filter to view the correct ledger balance.