Fusion Enterprise understands that billing is a critical function of any practice. As such, we have ensured that you can run all of your practices billing through Fusion Enterprise and make it as easy as we can. This series of introductory articles will cover the important aspects of managing Patient Statement with Fusion Enterprise.
Jump to Section [Statement Types] [Non-EPS Statement] [Non-EPS with Detail Statement] [EPS Statement]
Statement Types
Most patient statements pattern themselves after an EOB and the complicated procedure of insurance billing. These statements confuse patients and result in many unnecessary phone calls to billing departments. We have spent considerable time simplifying the patient statement so it is easy for the patient to read and understand.
There are three main statement types that ship with Fusion Enterprise – non-EPS, EPS, and Text. Each of these also has a detailed version. (Other statement forms may be available on the Client Portal.) As explained earlier in the chapter, the statement type will dictate the information sent to the patient. Thus, an EPS statement type must be used in order for the patient to be billed for EPS charges, even if that view was showing in the output list at the time of the batch creation.
The header (shown below) is identical for all statements, except the Text Statement.
The header shows the statement date, the patient name, and account/case number, the facility attended, the remittance address, and the total amount due. The Logo and Credit Card graphic may both be changed by going to Administration | General Info | Graphics.
Non-EPS Statement
This statement calculates the Patient Due by adding two sums: the amount due for all dates of service at an invoice state of Bill Patient, plus the amount due for any non-insurance-billable charges (regardless of invoice state). Non-EPS does not include the amount you have estimated to collect from the patient at each visit.
The Visit Summary section shows the breakdown of each visit and the amount for which the patient is responsible for that visit. At the bottom of this section is a total for each of the columns.
Statement Detail Columns
|
Date of Service |
Date of the patient visit. |
|
Status |
Status can be either patient due or pending an insurance carrier. |
|
Charges |
Total adjusted charges. |
|
Insurance Charges |
Total amount of money charged to the insurance company. |
|
Other Charges |
Total amount of money that is non-insurance billable. |
|
Insurance Payments |
Total amount of money paid by the insurance. |
|
Adjustments |
Total amount of money adjusted off for the charge. |
|
Patient Responsibility |
Total amount owed by the patient for that visit. |
Below the Visit Summary is an optional Aging bar that you may choose when generating statements.
Non-EPS with Detail Statement
This statement is the same as the Non-EPS statement type, except it has three additional sections: Charge Detail, Payment Detail, and Charge Code Glossary.
The Charge Detail section, seen below, lists the individual charge information for each visit.
Charge Detail Columns
|
Date |
Date of the patient visit. |
|
Status |
Status can be either patient due or pending an insurance carrier. |
|
Code |
Charge code (CPT) charged on that visit. |
|
Units |
Number of units charged |
|
Total Charge |
Unit price multiplied by the Units. |
|
Insurance Payments |
Total amount of money paid by the insurance. |
|
Adjustments |
Total amount of money adjusted off for the charge. |
The Payment Detail section, seen below, lists the individual payments made by the patient and any amount refunded.
Patient Payment Detail
|
Date |
Date payment was posted to the system. |
|
Type |
Type of payment (Check, Cash, Credit Card) |
|
Identifier |
Description entered for the payment |
|
Amount |
Amount of payment |
|
Refunded |
Total amount refunded against a particular payment. |
These payments are displayed even if the money has not been posted and is listed as patient unapplied. At the bottom of this section are a total of patient payments.
EPS Statement
This statement calculates the Patient Due by adding three sums: the amount due for all dates of service at an invoice state of Bill Patient, plus the amount due for any non-insurance billable charges (regardless of invoice state), plus the Estimated Patient Schedule amount as entered in the patient’s case for any visit at an invoice state of Pending insurance.
The Statement Detail area is the same as on the non-EPS statement, except the Patient Responsibility column uses the Estimated Payment Schedule for visits that are still Pending insurance.
EPS with Detail Statement
This statement is the same as the EPS statement but includes the additional information as the Non-EPS with Detail statement.
Text Statements
The Text Statement (Detailed) contains the same information as above but is in a machine-readable format. These are used with outside statement printing services. They dump all of the statement information and the 3rd party reads and parses this information and puts it in their own format.