About the Patient Ledger

The Patient Ledger is where all financial transactions are posted to a patient's account. All charges, payments, write-offs, transfers and overall financial account maintenance are performed from the Patient Ledger, using the Sheet Bar optionsSheet Bar options on the left side of the screen. Click the links in the Sheet Bar Options section of this topic to learn how to post transactions to an account.

Most of the fields on the Patient Ledger screen itself are read-only, but you can adjust the view of the screen using the Viewing and Grouping options discussed in this topic, and you can use Demographics button to edit patient information or verify insurance coverage. Click the links in each section of this topic for more information.

Video Demo

Click the image below to view a video demonstrating the following Patient Ledger processes:

• Payment Refunds (Allocated Unassigned Payment and Unallocated Unassigned Payment)
• Insurance Refunds
• Correction Recommendations

Using the Patient Ledger

1. In the Financial Management module, select the Patient Ledger Sheet Bar optionPatient Ledger Sheet Bar option under the Billing heading on the left side of the screen. The Patient Ledger screenPatient Ledger screen appears. (From the RCM module, clicking Patient Ledger from the RCM Ledger Sheet Bar takes you straight to the Patient Ledger.)

   

    

   

2. Click the patient information shown highlighted in blue in the Balance InformationBalance Information section to select a patient record.

   The information in this section defaults in from other areas of the system. Click the links below for more information.

   1. • Patient InfoPatient Info

        The patient's account number, name, age, date of birth and sex are displayed here.

      • RemarksRemarks

        Click the icon to the right of the patient info to read or create Remarks on the account. The Remarks feature is useful for noting finance-related details. For example you can note that you have explained to the patient the level of benefits or tried to collect a co-pay or deposit.  Click here to learn how to read or create Remarks.

      • BatchBatch

        The current batch being used for posting transactions is displayed in blue text just below the patient name. All transactions you complete on the patient ledger will be posted to this batch. You can select a different batch or create a new one. Click here to learn how.

      • Aging informationAging information

        There are five columns within this section which represent aging amounts (from left to right): 0-30, 31-60, 61-90, 91-120, and 120+ days based on the transaction date of the charge.

        1. • Account: Displays the total balance for the entire account.

           • Patient: Displays the portion of the balance that is assigned to the patient.

           • Insurance: Displays the portion of the balance that is assigned to an insurance carrier on the patient’s account.

         

      • UPUP  (unassigned payment)

        UP: Displays the total of any Unassigned Payments posted to the patient ledger that have not been associated to a charge. If this number is greater than 0, then there is money that can still be allocated to charges. If the charges have reached a 0 balance, then the patient could be owed a refund.

         

         

    

3. All Transactions posted to the selected patient record (account) display in the Transaction ListTransaction List in the middle of the screen.

   

   • You can filter and sort this list using the Viewing and Grouping OptionsViewing and Grouping Options at the bottom of the screen.

     You can adjust the way transactions are displayed in the Transaction List using the following options:

     1. • ViewView
          • Recent TransactionsRecent Transactions

            Displays all transactions posted in the previous 30 days, including parent and child transactions.

          • Charges OnlyCharges Only

            Displays all parent transactions. You can view all child transactions by clicking the plus sign next to a parent transaction.

          • Open Items OnlyOpen Items Only

            Hides all charges that have reached a 0 balance, and displays all other transactions. You can view all child transactions by clicking the plus sign next to the parent transaction.

          • Show InactiveShow Inactive

            When left unchecked, only active transactions will be viewable on the transaction list. When checked, both active and inactive transactions will be displayed.

          • Child Transaction TreeChild Transaction Tree
            1. • Collapse allCollapse all

                 Hides all child transactions from view

               • Expand allExpand all

                 Displays all child transactions

        • Group ByGroup By
          • ChargeCharge

            Groups transactions by charges (default)

          • CaseCase

            Group transactions by Case

          • Date of ServiceDate of Service

            Groups all transactions with the same date of service together

          • Entry OrderEntry Order

            Displays all charges in the order they were posted on the ledger

        • Group TotalsGroup Totals

          The Group Totals will display the totals for the transactions included in the option you selected in the Group By section. If you select a different Group By option, the totals will recalculate based on your new selection.

   • When you see next to a Transaction, you can click this symbol to view Child Transactions (payments, write-offs, notes) associated to the Parent Transaction.
   •  Click herehere to learn more about the fields in this section.

     Displays a list of all transactions posted to the account. Click the next to a transaction to see its "child" transactions (i.e. payments posted to a charge).

     1. • AA

          If checked, indicates the transaction is active.

        • ItemItem

          Displays the CPT® code for procedures and supply resource item charge lines

        • TR DateTR Date

          Displays the transaction date for the entry. For a charge, this would be the date or service. For all other transactions, this date can be manipulated at the time of posting.

        • TRTR

          Displays the quick code of the transaction type. Transaction types:

          • Charges/Charge Corrections

          • Payments/Payment Corrections

          • Write-offs/Write-off Corrections

          • Transfers/Transfer Corrections

          • Unassigned payments/Unassigned Payment Corrections

          • General Notes

        • AmountAmount

          Displays the amount of the transaction

        • DebitDebit

          If the transaction entered was a debit, the amount will also show in this column, so the user can quickly see that the transaction was added to the patient’s accounts receivable.

        • CreditCredit

          If the transaction entered was a credit, the amount will also show in this column, so the user can quickly see that the transaction subtracted from the patient’s accounts receivable.

        • JCJC

          Displays the journal code associated to the transaction (will be blank for charge line items).

        • ProviderProvider

          The surgeon rendering services for this transaction

        • AAAA

          Displays if the charge was marked as Accept Assignment (can be set as a default in the insurance plan dictionary). When checked, the facility acknowledges the payment by the insurance carrier as payment in full (for that payor) for services rendered.

        • GCGC

          Displays if the charge was marked as Generate a Claim (can be set as a default in the insurance plan dictionary). When checked, the charge will appear as an eligible billable item in the insurance billing section of the Financial Management module. If the charge should not be included on an insurance claim, then GC should be left unchecked for that charge line item.

        • Bill DateBill Date

          Displays the latest date the charge was billed. If there is a date in this field, then the charge will not be in the queue of the insurance billing section of the Financial Management module. If this field is blank, the charge has either not yet been billed or it has been marked as re-billed and will remain blank until the charge is billed for a second time.

        • Pat RespPat Resp

          Displays the portion of the charge due from the patient. Adding an amount in this field at the time of charge entry will add the amount to the patient balance area in the aging columns at the top of the Patient Ledger screen (Balance Information area) and deduct from the insurance balance.

        • DueDue

          Displays the total unpaid amount remaining on the charge

      

4. The screen regionscreen region at the bottom right of the Patient Ledger displays further information about the transaction you highlighted from the Transaction List. The fields shown vary based on the type of transaction and are read-only. Click the links for more information on the fields displayed for each type of transaction:

   

1. • ChargeCharge

     1. • BT#BT#

          Billing Transaction Number- used to identify all financial transactions. If you receive an error message while billing insurance, the transaction will be identified by this number.

        • Transfer to BG - This box is checked by the system when a user has used the Transfer to BG function to transfer a transaction from one billing group to another. For more information, see Transfer to BG.

        • Billing Group - Name of the Billing Group associated to the charge

        • CPT® - CPT®  code associated to the procedure

        • Mod CPT® Modifier Quick Codes (up to 4)

        • POS Place of Service code for where the procedure was performed

        • Units Number of units of the supply/resource or service associated to the charge

        • Billed to - Name of the current role the charge resides with (PI, SI, TI, PG, or SG)

        • On - Date of service. This is not the date the charge was billed. If the charge has been billed, the Bill Date displays in the Transaction List.

        • TOB - Type of Bill

        • Collector - Passport of the current Collector associated to the charge

        • RCM Date - Current follow-up date associated to the charge.

        • DRG - Diagnostic Related Group if one has been entered (Inpatients only)

      

   • PaymentPayment

     • BT#BT#

       Billing Transaction Number- used to identify all financial transactions. If you receive an error message while billing insurance, the transaction will be identified by this number.

     • Transfer to BG - This box is checked by the system when a user has used the Transfer to BG function to transfer a transaction from one billing group to another. For more information, see Transfer to BG.

     • Received From - Role and Name from whom the payment was received

     • Journal Code - The code associated to the transaction

     • Type - Check, Cash, Credit Card or EFT

     • Check # - this field is dynamic and will change based on the Type. If the Type is Check, the number will display, if Credit Card the Card number will be displayed, if EFT, the routing number will display.

     • Routing # - The bank routing number

      

   • Unassigned PaymentUnassigned Payment

     1. • BT#BT#

          Billing Transaction Number- used to identify all financial transactions. If you receive an error message while billing insurance, the transaction will be identified by this number.

        • Transfer to BG - This box is checked by the system when a user has used the Transfer to BG function to transfer a transaction from one billing group to another. For more information, see Transfer to BG.

        • Billing Group - Name of the Billing Group associated to the charge

        • From - Role and Name from whom the payment was received

        • Journal Code - The code associated to the transaction

      

   • General NoteGeneral Note

     • BT#BT#

       Billing Transaction Number- used to identify all financial transactions. If you receive an error message while billing insurance, the transaction will be identified by this number.

     • Transfer to BG - This box is checked by the system when a user has used the Transfer to BG function to transfer a transaction from one billing group to another. For more information, see Transfer to BG.

     • The note's text appears in the comments box.

   • TransferTransfer

     1. • BT#BT#

          Billing Transaction Number- used to identify all financial transactions. If you receive an error message while billing insurance, the transaction will be identified by this number.

        • Transfer to BG - This box is checked by the system when a user has used the Transfer to BG function to transfer a transaction from one billing group to another. For more information, see Transfer to BG.

        • Transfer From: Role and Name from whom the amount originally resided with

        • Transfer To: Role and Name of whom the amount was moved to

        • Journal Code: The code associated to the transfer

      

   • DebitDebit

     • BT#BT#

       Billing Transaction Number- used to identify all financial transactions. If you receive an error message while billing insurance, the transaction will be identified by this number.

     • Transfer to BG - This box is checked by the system when a user has used the Transfer to BG function to transfer a transaction from one billing group to another. For more information, see Transfer to BG.
     • Journal Code - the Journal code associated to the Debit

   • Write offWrite off

     • BT#BT#

       Billing Transaction Number- used to identify all financial transactions. If you receive an error message while billing insurance, the transaction will be identified by this number.

     • Transfer to BG - This box is checked by the system when a user has used the Transfer to BG function to transfer a transaction from one billing group to another. For more information, see Transfer to BG.

     • Received From: Role and Name from whom the write off was taken

     • Journal Code: The code associated to the transaction

      

   • Payment Plan InfoPayment Plan Info

     If the selected charge is billed under a Patient Payment Plan to the Plan Owner of that case’s active Payment Plan, the information listed below about the plan is displayed in a box at the foot of the Ledger. These fields auto-populate from the Payment Plan Details and are not editable here. To learn more about Patient Payment Plans, click here.

     • Next Payment Date
     • Next Payment Amount
     • Payoff Amount
     • Amount per Payment
     • Number of Payments
     • Last Payment Date
     • Payment Plan Total

5. To view a transaction in even more detail or to edit it, double-click the transaction from the list. The Details Page for the selected transaction appears. Click the links below to learn what fields you can edit on the Details page for each transaction type:

   • Charge Details Page

   • Payment Details Page

   • Unassigned Payment Details Page

   • General Note Details Page

   • Transfer Details Page

   • Debit Details Page

   • Write off Details Page

   • Correction Details Page

6. To view Insurance and Case information for a Transaction, highlight it in the Transaction List. The details of the Transaction populate the Transaction DetailsTransaction Details section:

   

   • Insurance InformationInsurance Information

     After you select a transaction from the Transaction List, this area populates with information that pulls from the Demographics module.

     1. • Payor: The name of the insurance carrier name currently responsible for payment.
        • Insured ID: The patient's insurance ID.
        • Grp name: The patient's group name
        • Grp #: The patient's group number
        • Pre-Auth #: The pre-authorization number for the case
        • Eff Date: The effective date of the insurance policy
        • Exp Date: The expiration date of the insurance policy, originally entered in the demographics module
        • Copay Amt: The copay amount for the patient, originally entered in the Insurance Policy section of the demographics module
        • Deductible Amt: The deductible amount for the patient, originally entered in the Insurance Policy section of the demographics module
        • Phone #: The phone number used when verifying the insurance policy, originally entered in the insurance verification section of the demographics module
   • Case InformationCase Information

     After you select a transaction from the Transaction List, this area populates with information that pulls from other areas of AmkaiOffice.

     1. • Name: The free text name given to the case
        • DOS: The date of service for the appointment associated to the case
        • Status: The status of the case. Pulls from the CDM module.
        • Case Prv: The provider scheduled to perform this case
        • Ref Prv: The referring provider for the case
        • Case Classification: The classification associated to the case (custom built dictionary)
        • Case Manager: The person appointed as case manager
        • DX1-DX3: Diagnosis codes associated with the selected transaction line. Pulls from the charge entry section of the Financial Management module.
7. Depending on your facility's workflow and procedures, you may use the following Action Buttons to the right of the Transaction Details section to verify key information before proceeding with posting financial transactions:

5. • Demographics buttonDemographics button

     Click this button to launch the Demographics screen, where you can make changes to the patient's demographic information, or verify insurance coverage. Click here to learn how to edit this screen.

   • Appointment Summary buttonAppointment Summary button

     Click this button to view a summary of all appointments for the patient. Click here for more information.

   • Patient Statement History buttonPatient Statement History button

     To create and print a report showing the history of when patient statements were generated:

     1. Click the Patient Statement History button.

     2. Select the date range for the report. Only statements run in this range will appear on the report.

     3. Click OK.

     4. A new tab will open with the patient statement history report.

     5. To print, click the green HP button at the top left of this window.

8. To perform account maintenance and/or post transactions to the account, use the Sheet Bar options on the left-hand side of the screen.

Sheet Bar Options

Use the Sheet Bar optionsSheet Bar options on the left side of the screen to perform financial maintenance to the account. When you click different types of transactions, the options under Special change accordingly as described below. Click the links below to learn more about the Sheet Bar options.

Go

• Back

General

• Charge
• Unassigned Payment
• General Note
• On Demand Claim
• Account Maintenance
• Patient Statement

Special (Options that appear when you highlight an Unassigned Payment on the Ledger)

• Correction
• Allocation Payment
• Note

Special (Options that appear when you highlight a Charge on the Ledger)

• Correction
• Auto Posting
• Payment, Write off, or Transfer
• Debit
• Note

Special (Options that appear when you highlight a Payment on the Ledger)

A Payment is displayed on the Ledger as a Child Transaction of the Charge to which it was posted. To view a payment, click the next to the Charge.

• Correction
• Note

Transfer to BG

• Transfer to BG (Billing Group) & Setup

 

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