Charge

The General > Charge Sheet Bar option on the Patient Ledger screen in the Financial Management module launches the Charge Entry Screen which is used to post charges to a patient's account.

You can also launch this screen by selecting Entry Screens > Charge Entry from the Financial Management Sheet Bar. You will then be prompted to select a patient and a batchselect a patient and a batch.

Click the to select a Patient and a Batch to post Charges to. The Charge Entry screen will then launch.

While posting charges, you can also post any payments or write-offs on the same screen.

Quick Start Guides

Click here to view a video demonstrating how to post a charge to the patient ledger.

Click here to view a diagram covering the basic steps required to post a charge.

Prerequisites for posting charges to a patient's account

Before you can post charges to an account, the Appointment Status field in the CDM (Clinical Documentation Management) module in AmkaiOffice must be updated Performed or Partially Performed, Billable.

To post charges to a patient's account

Open the Financial Management module.
Under the Billing heading on the Sheet Bar, select the Patient LedgerPatient Ledger. The Patient Ledger screenPatient Ledger screen appears. From this screen:
- Select a patient and the batch to post charges to:
- - Click the patient information highlighted in blue in the upper left of the Patient Ledger to select a patient record. You are then returned to the Patient Ledger screen.
  - Click the batch name underneath the patient information to select a different batch or create a new one.
- Select General > ChargeGeneral > Charge from the Sheet Bar. The Charge Entry screenCharge Entry screen appears.
The Balance InformationBalance Information section on the Charge Entry screen is read-only. Click herehere to learn more about all the fields in this section.
1. - Patient InfoPatient Info
    
    The patient's account number, name, age, date of birth and sex are displayed here.
  - PeriodPeriod
    
    Displays the Period you will be posting charges to
  - BatchBatch
    
    Displays the Batch you will be posting charges to. If you need to post the charges to a different batch, return to the Patient Ledger screen to select a different batch create a new one. Click here to learn how.
  - Aging informationAging information
    There are five columns within this section which represent aging amounts due (from left to right): 0-30, 31-60, 61-90, 91-120, and 120+ days based on the transaction dates of charges posted to the account. Point your mouse to an amount to see a message indicating how aged the amount is.
    
    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
    
    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.
In the Claim Information and Action Buttons sectionClaim Information and Action Buttons section, most of the information defaults in from other areas. Typically, users will need to update the following fields:
- To select a case other than the most recent one, click next to the Case Date/Name field.
- Edit or add any post-operative DX CodesDX Codes, if they are different from the pre-operative codes. If you are working on AmkaiOffice Version 3.16, you may enter a total of 9 codes. If, however, you are working on Version 3.17b or later, you may add up to 18 codes.
  Any pre-operative diagnosis codes entered in Scheduling appear in this section. You can enter any post-operative diagnosis codes in the drop-down lists here. Text above the diagnosis entry box indicates whether the Primary Insurance needs ICD-9 or ICD-10 codes.
  - To add a diagnosis code, click the plus sign icon and select the code from the drop down list or type in the code.
  - To remove a code, click it and then click the minus sign icon.
  - To move a code up or down the list, select it and use the up or down arrow.
- If the Appointment field is highlighted in red, go to the CDM module and set the Appointment Status field to Performed or Partially Performed, Billable.
- Click the Import from CDM button to pull in any charges generated in that module.

Click herehere below to learn more about the fields and buttons in this section.

Claim Information

Action Buttons

Case Date/NameCase Date/Name

Displays the case charges will be posted to. Defaults to the most recent case. To select a different case, click the check mark icon.
Billing GroupBilling Group

Displays the billing group associated to the selected case. Click the drop down arrow select a different billing group.
Apply toApply to

Displays the responsible party who will be billed first for the charge. If there is an insurance carrier associated to the Billing Group, it will be the insurance claim office listed in the Billing Group. If not, this field will display the Primary Guarantor.
Assoc. Case Date/NameAssoc. Case Date/Name

Users have the ability to link cases to each other in the Demographics module > Case screen. If the selected case has a linked case, will show here in this read-only field. Practice Management Business Entities typically use this feature to link post-op follow-up appointments to the surgical case.
FacilityFacility

Defaults to the name of the Facility where the case was performed. To change the Facility, select a different one from the drop down list.
Ref PhysRef Phys

Defaults to the Referring Physician as assigned in Scheduling or CDM. To change the Referring Physician, select a different one from the drop down list.
AppointmentAppointment

Read-only field that shows the appointment for the selected case. Appointment date, status, and type will show in this field. The field will be red if the appointment cannot be charged. You can make the appointment chargeable by setting its status to Performed, or Partially Performed, Billable in CDM.
DX CodesDX Codes
Any pre-operative diagnosis codes entered in Scheduling appear in this section. You can enter any post-operative diagnosis codes in the drop-down lists here. Text above the diagnosis entry box indicates whether the Primary Insurance needs ICD-9 or ICD-10 codes.
- To add a diagnosis code, click the plus sign icon and select the code from the drop down list or type in the code.
- To remove a code, click it and then click the minus sign icon.
- To move a code up or down the list, select it and use the up or down arrow.

ContractContract

If the selected Billing Group/Apply To insurance carrier has an associated contract, you can click this button to view the contract details. If the button is not active, no contract has been associated to the selected Billing Group/Apply To. For more information, see Contracts.
Verification InfoVerification Info

Click this button to open the Insurance Verification screen. Here, you can verify insurance authorization, see estimated revenue or view/modify any other pertinent information related to insurance coverage. If you are using AmkaiOffice Version 3.16x or 3.17x, see Verifying Insurance Coverage for more information. However, if you are using AO Version 3.18x, see Verifying Insurance Coverage V. 3.18 or later.
Import from SBsImport from SBs (Superbill)

This option is used for Practice Management entities only. It enables you to import charges from the Superbill.
Appointment SummaryAppointment Summary

Click this button to show any range of past and future appointments for this patient. Click here for more information.
Import from CDMImport from CDM

Click the Import from CDM button to pull in charges generated in that module.

Click the plus sign icon next to the Charge Line sectionCharge Line section to add a new charge. The fields in the Charge Line are read-only. In the Charge Information section, you will enter the details of the new charge. After you complete the Charge Information section, the fields in the Charge Line section populate with data you added. You can click the Sort button to sort the list of charges so that those with the highest rates of reimbursement display first.
To add/edit information for a new charge or an existing charge, highlight the charge in the Charge Line section. In the Charge Information SectionCharge Information Section, complete or edit the fields as described in following links. Mandatory fields are marked with a red X on the screen.
- Trx Date(s)Trx Date(s) (Mandatory)
  
  The transaction from and through dates associated to the charge default here (usually equal to the date of service). However, you can enter a different date. If the from and through dates are the same you are only required to enter the from date.
- Rend PrvRend Prv (Mandatory)
  
  Identify the rendering provider for this charge. This field will default to the case provider identified on the case screen in Demographics. You have the option to edit this field using the drop down arrow.
- Procs or S/RProcs or S/R (Mandatory)
  
  Select either the Procs (procedure) or S/R (supply/resource) radio button to indicate what the charge you are posting is for. If you select Procs, active procedure codes (as entered in the Procedure dictionary) will be available to select from the drop-down list.
  
  If you select S/R, supplies/resources that are marked as Billable are available to select from the drop-down list. Click Alt + D to access either the procedure or supply/resource dictionary to add or activate items.

- SORSOR (Mandatory)
  
  (Source of Revenue):Use the drop down menu to select the source of revenue for this charge. SOR can be defaulted in the procedure dictionary. SOR are often used to apply discounts to second and additional procedures.

Note: You can bill both by Procedure (flat rate by Procedure) and for Time & Materials for the same case, if needed. Before you can post charges (bill) for supplies/resources, Time and Material Billing must be enabled in the System Administration module. See Time & Material Billing. Fees are associated to Procedures in the Fee Schedule in the System Administration module. (See Fee Schedule).

Click herehere below to learn more about all the fields in this section, including the non-mandatory ones.

Trx Date(s)Trx Date(s) (Mandatory)

The transaction from and through dates associated to the charge default here (usually equal to the date of service). However, you can enter a different date. If the from and through dates are the same you are only required to enter the from date.
Rend PrvRend Prv (Mandatory)

Identify the rendering provider for this charge. This field will default to the case provider identified on the case screen in Demographics. You have the option to edit this field using the drop down arrow.
Sup PrvSup Prv

If needed, select a supervising physician using the drop-down list.
Ref PrvRef Prv

This field will default to the referring physician identified at the top of the screen under the “Claim Information section”. If needed, you can select a different physician from the drop-down list.
FacilityFacility

This field will default to the facility identified at the top of the screen under the “Claim Information section”. You can select a different facility using the drop-down list.
Procs or S/RProcs or S/R (Mandatory)

Select either the Procs (procedure) or S/R (supply/resource) radio button to indicate what the charge you are posting is for. If you select Procs, active procedure codes will be available to select from the drop-down list. If you select S/R, supplies/resources that are marked as Billable are available to select from the drop-down list. Click Alt + D to access either the procedure or supply/resource dictionary to add or activate items.
UnitsUnits

Enter the units for this charge. Units may affect the Amount if the procedure calc method is set to “flat fee per unit” in the procedure dictionary.
AmountAmount

Total amount charged for the transaction. This Amount is automatically calculated based on the procedure calc method set in the procedure dictionary.
Pt RespPt Resp

(Patient Responsibility): You can enter the portion of the amount the patient will be responsible for. This will result in the account now being eligible for a Patient Statement even if the charge is currently set as due from insurance carrier.
SORSOR (Mandatory)

(Source of Revenue):Use the drop down menu to select the source of revenue for this charge. SOR can be defaulted in the procedure dictionary. SOR are often used to apply discounts to second and additional procedures.
Revenue CodeRevenue Code

Use the drop down menu to select the revenue code for this charge. This can be defaulted in the procedure dictionary.
cmcm

(Calculation Method): This is a read-only field that will show the calculation method set in the procedure dictionary for the selected procedure.

M1 - M4M1 - M4

(Modifier 1 – 4): Use the drop down menu to select any modifiers associated to this charge. Modifiers can be defaulted to a procedure code in the procedure dictionary.
CPTCPT ®

This is a read-only field where you can see the CPT-4® code that has been associated with the selected procedure. CPT-4® codes are associated to procedure codes in the procedure dictionary.
Dx PntrsDx Pntrs

(Diagnosis Pointers): The DX pointers will default to reference the DX codes identified in the Claim Information section. For AmkaiOffice Version 3.16x, the DX pointers default in beginning with 1 to the last code set. For example, if you entered a DX code in slots 1 and 2 in the Claim Information section, the DX pointer field would display 12. AmkaiOffice Versions 3.17x and later, the DX pointers are letters. The DX Pointers default to begin with A to the last code set. For example, if you entered a DX Code in slots A and B in the Claim Information Section, the DX Pointer field would display AB. You can modify the pointers at this time. Pointers are displayed without spaces or commas in this field. This is a free text field.
ICD 1 - 3ICD 1 - 3

(ICD-9 or 10 Procedure Code): Use the drop down list to select any ICD procedure codes associated to this charge. ICD procedure codes can be defaulted in the procedure dictionary.
Co-payCo-pay

This is a read-only field where you can see the copay amount. This data comes from the Insurance Policy Verification screen (which takes into consideration the contract on file)
PayIndPayInd

(Payment Indicator): If the selected Procedure and associated CPT® code has a Medicare Payment Indicator code associated to it the code will display in this field. Payment indicators are added to the CPT-4® code in the CPT® dictionary.
Type of BillType of Bill

You can free text the type of bill associated to this charge. Type of bill can be defaulted in the appointment type dictionary and will pull based on the type of appointment associated to the selected case. You can hover over the code that defaulted in to see what each digit represents.
AAAA

(Accept Assignment): Check this box if your facility is accepting assignment. To default this field and/or make it modifiable as needed at the charge screen, use the insurance plan dictionary.
GCGC

(Generate Claim): Check this box if you want to generate a claim. To default this field and/or make it modifiable as needed at the charge screen, use the insurance plan dictionary.
Bill PGBill PG

Check this box if you will automatically be billing the primary guarantor. To default this field and/or make it modifiable at the charge screen use the insurance plan dictionary.
Anesthesia CalculationAnesthesia Calculation

This field is only active if the Business Entity type is Anesthesia. It will display how the system calculated the amount being billed.
Additional InformationAdditional Information

Use this button to enter claims information (HCFA or UB). Click here for more information.

Repeat these steps for each additional charge to be posted to the patient's account.
Click Save to post the charges to the patient ledger. Click Save & Next to post the charges and select a new patient from the Master Person Index.
A pop-up message will alert you to any unallocated payments on the account. Click OK on this message to allocate the payment(s). Click here to learn how to post an unallocated payment.
If you wish to post a payment or write off at this time, you can do so in the Payment/Write Off section. Click herehere to learn how.
To post a payment from the Charge Entry Screen
1. 1. Scroll to the bottom of the screen to the Payment/Write off section. Click herehere to see a screen shot.
  2. Payment: Enter any payment amount received at the time of the charge in this free text field.
  3. Code: Select or modify the journal code to be used. Use the Alt + E or Alt +D hot keys to modify or add items to the Journal Code Dictionary if needed. This code is mandatory if a Payment amount is entered.
  4. Type: Enter the type of payment received (Card, Check, Cash, and EFT). This is a mandatory field if a payment is entered.
  1. - Check # / Routing #: If the payment type selected is Check, the system will open two additional fields on the screen. Enter the check number and routing number, if desired, for the transactions to be posted. NOTE: If you are working with a check that includes payments for several accounts the system will hold the check number as you select each new account to post payments to. Once all of the accounts have been paid for that check, remember to clear the field and enter the new check number for the next check being posted. Also, keep in mind when entering the check number that the system offers several reports that will provide the option to search for accounts that have been referenced on a specific check number. Users should be consistent in how the check numbers are entered to aid in searching by check number.
    - Card: If the payment type selected is Card, the system will open a field for the user to enter the credit card number to be referenced for the payment. It is recommended for security reasons that you enter only the last four digits.
    - Checking Account #/Routing #: if the type of payment selected is EFT, the system will open two fields for the user to enter the checking account # and routing number to be referenced for the transactions.
  1. Wr. Off 1(Write off 1): You can enter a write-off at this time in this field. A write-off amount might already be defaulted depending on the associated contract or the source of revenue indicated for this charge.
  1. - Code: Select or modify the journal code to be used. Use the Alt + E or Alt +D hot keys to modify or add items to the Journal Code Dictionary if needed. This code will be mandatory if a Write- off 1 amount is entered.
    - Group Code: Use the drop down menu to select the appropriate group code for the associated write off. If a reason code has been entered, the group code will become a mandatory field. Use the Alt + E or Alt +D hot keys to modify or add items to the Denial Group Code dictionary. For clients submitting claims in the x12 format these codes are required for claims to process successfully.
Note: Group and reason codes are required for processing electronic claims that include write offs. It is recommended that you enter these codes when you enter write off information.
1. 1. - Reason Code: Use the drop-down menu to select the appropriate reason code for the associated write off. If a group code has been entered the reason code will become a mandatory field. Use the Alt + E or Alt +D hot keys to modify or add items to the Denial Reason Code dictionary. For clients submitting claims in the x12 format these codes are required for claims to process successfully.
  1. Wr. Off 2 (Write off 2): You can enter a second write-off at this time. A write-off amount might already be defaulted depending on the associated contract or the source of revenue indicated for this charge.
  1. - Code: select or modify the journal code to be used. Use the Alt + E or Alt +D hot keys to modify or add items to the Journal Code Dictionary if needed. This code will be mandatory if a Write- off 2 amount is entered.
    - Group Code: Use the drop down menu to select the appropriate group code for the associated write off. If a reason code has been entered the group code will become a mandatory field. Use the Alt + E or Alt +D hot keys to modify or add items to the Denial Group Code dictionary. For clients submitting claims in the x12 format these codes are required for claims to process successfully.
    - Reason Code: Use the drop down menu to select the appropriate reason code for the associated write off. If a group code has been entered the reason code will become a mandatory field. Use the Alt + E or Alt +D hot keys to modify or add items to the Denial Reason Code dictionary. For clients submitting claims in the x12 format these codes are required for claims to process successfully.
  1. Note: You can add a free text a note associated to this charge line.
  2. Print on Statement: Check this box if you would like the above note to be printed on the patient statement. By leaving this check box unchecked, the note will continue to be an internal note only.
  3. Print on Claim: Check this box if you would like the above note to be printed on the claim form. By leaving this check box unchecked, the note will continue to be an internal note only.
  4. Click Save to post the payment or write off.