HMO Billing Staff
The Billing Module houses the payment transaction features in which users can produce invoices, reports and analytics, and expenses. Users of this module make sure that these transactions are not just properly documented but also well balanced and organized with reports and census. This module is important to ensure that these payment transactions go smoothly from clinic staff commissions to billing clinic services.
This module has three primary users namely Head – Billing, HMO Billing Staff, and Cashier. Each of these users have their own role and privileges to ensure the patient’s clinic journey. In this tutorial, we’ll discuss the one who processes the HMO Statement of Accounts and other billing reports: HMO Billing Staff.
HMO Billing Staff
The HMO billing staff have the full access Patient Encounters, Invoices, SOA Management, and Billing Reports. Their main work is to ensure that the patients get the corresponding coverages for the clinic services they avail.
CRUD = Create, Read, Update, Delete.
|Billing||HMO Billing Staff|
|Payment Configurations||Manages Discount Types, Payment Methods, Tax Types, Sales Tax, Purchase Tax, Price List, Sales Price List, Purchase Price List||RU|
|Patient Encounters||Manages activities associated with patient encounters||CRUD|
|Invoices||Manages invoices created during encounters||CRUD|
|Payments||Manages invoice payments||R|
|Clinic Services||Manages clinic services||R|
|Expenses||Manages clinic expenses||NA|
|SOA Management||Manages statement of accounts of partners||CRUD|
|Billing Analytics||Manages billing analytics||RU|
|Billing Reports||Manages billing reports||CRUD|
|Physical Medical Exam||CRUD|
Payment Configurations and Clinic Services
These payment configurations and clinic services refer to the Administrative module’s Billing settings namely Discount Types, Payment Methods, Tax Types, Sales Tax, Purchase Tax, Price List, Sales Price List, Purchase Price List. Only Head – Billing users can access this.
Patient encounters pertain to the list of active patients inside the clinic. Once Billing > Encounters is accessed, users will see active patients inside the clinic with their corresponding balance and status, as well as their current queue.
This is where users can record the payments that they received from the patients for the services they availed. Users can update the invoice’s OR number, services that the patient availed as well as its corresponding price, discount, or coverages, add notes for the invoice, determine the tax complication, staff commissions, etc. Users can also print these.
The system also has a way of tracking the payments made by a specific patient. This includes the different payment methods and accommodating staggered payments.
To record a payment, click the “Add Payment” button to choose a payment method. A prompt will appear asking for the amount to be paid. Users have the ability to accept staggered payments from the patients which will be duly recorded in the payment history as well as add noted about the payment made. Click “Pay” to save the payment transaction.
Simply scroll down the Invoice page to go to Payments and click the payment history to view the history per patient.
Users of the Billing Module can create an SOA transaction through Billing > Reports > AR Reports wherein it shows the list of all transactions linked to a clinic partner.
Users can produce a Statement of Accounts report by clicking the “Add SOA” button found on the upper right corner and then the user will be redirected to the New SOA page.
There, users need to fill out necessary details such as Account Type, Period Covered, External SOA no., LOA no., Payment Terms, Date Received, and Aging Days. To select which SOA transactions to include, simply tick the checkbox next to the patient’s name or search for the patient’s name through the search bar and then tick the box. These SOA’s can also be printed.
These analytics can be found in the clinic dashboard and includes analytics vital to determine the clinic’s earnings.
This feature includes Total Sales, Daily Census, Doctor Billings, Government Billings, HMO Billings, Company Billings, and Billing Adjustments wherein users can view and produce reports for each of them respectively.
The first report that users will see is the Total Sales. This is where a summary of all the clinic transactions can be found composed of sales, expenses, number of patients, and total amount of payments per payment method. Users can filter the view by clicking the date field found on the upper left corner of the page.
When scrolled down, the users will find a list of the total transactions made per patient. The search bar on the upper right corner of the section will help the users in specifying the transactions made per patient.
Next is the Daily Census in which shows a summary or census of all the transactions per chosen date range. Users can also export a copy of this report through a CSV or XLSLX format by clicking the export button on the upper right corner of the page.
In the Doctor Billings, users can view the list of patient encounters, the service/product and their corresponding staff, the withholding tax, total share, disbursed, balance, and total of each of the payment transactions.
They can also choose which transactions are to be disbursed by ticking the respective boxes. Click “Mark as Paid” button when done selecting and then a prompt will appear to confirm the disbursement of commissions. To have a copy of the Doctor Billings report, click the export button found on the upper right corner of the page and then select which format the report is to be exported in.
In Government Billings, users can view the total list of transactions which used a government issued insurance which is also viewable per date range and per government insurance. To export the report, click the export button found on the upper right corner of the page and then select which format the report is to be exported in.
Users can view the list of patient encounters, the diagnosis, service/product and their corresponding staff, the payment type, and amount paid for each of the transactions. This is viewable per date range and per chosen HMO. Just click on the date field and then select desired date and click on the FIlter HMO bar to select specific HMO Billing transactions. Click the export button found on the upper right corner of the page to download a copy of the report.
In Company Billings, users can choose which Company Billing to view per chosen date range and per corporate partner. Click the export button found on the upper right corner of the page to download a copy of the report.
Billing Adjustment shows the voided and returned services/products per patient encounter. This includes details on the OR number, Patient Name, Clinic Staff, Diagnosis, Service/Product, Payment Type, Clinic Share, Doctor Share, its total and paid total. Click the export button found on the upper right corner of the page to download a copy of the report.