Other Case Info: Estimated Payment Schedule

Permissions! Clinic Staff must have Administrator, Billing Manager, Clinical Director, Front Office, Operations Manager, PTA, Staff Therapist, or Therapy Student Permissions assigned in order to manage Case Info.

Fusion Enterprise understands that the Front Office is a critical function of any practice. We have ensured that you can run all of your practices front office needs through Fusion Enterprise and make it as easy as we can. This series of introductory articles will cover the essential aspects of managing Cases with Fusion Enterprise.

In the therapy environment, it is difficult to know the exact charge for a patient before they leave your clinic. With this in mind, Fusion Enterprise uses an Estimated Payment System, which allows you to enter a payment schedule for a patient that determines how much they owe on each visit.

Choosing Edit Estimated Payment Schedule brings up the following dialog:

The Edit dialog works the same as Prescriptions and Diagnoses. You can Add, Edit or Delete

payment ranges from here. Clicking Add brings up the following dialog:

Multiple ranges can be entered to allow charging of different ranges for a given set of visits.

The following are a couple of examples of patients and their estimated payment schedules and how they are handled:

NOTE: Assume a patient has a co-pay of $10.00 and has a 10 visit cap, at which point the insurance will stop paying. A deal has been worked out with the patient to charge them $65.00 per visit after the 10th visit, but until that time they will owe their $10.00 co-pay. This would require 2 estimated payment ranges. The first one would be for all visits greater than or equal to 1 to pay $10.00. The second one would be for all visits greater than or equal to 11 to pay $65.00.

NOTE: Assume a patient has Health Care United as their carrier. From past history, we know that HCU pays $85.00 a visit. The patient has an 80/20 plan. From this, we can estimate that the patient will owe 20% of $85, or $17.00 a visit. This patient also has a $100.00 max out of pocket whereby the insurance carrier will then pay 100%. This means that on the first 5 visits you will collect $17.00 for a total of $85. On the 6th visit, you will collect $15.00 and on every visit after that, you will collect nothing. The estimated payment range would look as follows: