Overview

The Act: [ID] page provides details on the account selected from the Accounts page. Use the Act: [ID] page to review the outstanding balance summary, transaction activity, and collection activity on a guarantor account. 

It is comprised of 6 tabs:

The Active AR tab contains the activity detail of service line items on a guarantor account.

The Active AR tab shows all activity recorded on the particular account by transaction. Each transaction has a unique code based on the type of activity. Transaction activity is recorded as either financial or informational.

  • Financial activities are transactions that impact the financial status of the account, for example, service fees and payments. These transactions appear in the Amount column.

  • Informational activities are transactions that communicate an action that has occurred or that group transactions by activity types, for example, claims submission to a payer for a service fee. These transactions are memo items and do not appear in the Amount column.

Service fees line items are recorded with an activity code of SVCFE and are the primary means for grouping other transaction activity. Claims and payments are applied to service fee line items. Colors for different SVCFE line items are defined by the AR Grid Legend, accessed via the Show Legend link at the top of the tab.

  • The activity codes for payments are GPYMT (guarantor payment) and IPYMT (insurance payment). For example, IPYMT represents a payment received from a payer (insurance company). Posting an IPYMT transaction against a service fee line (SVCFE) has a direct impact on the balance of a SVCFE line item. This transaction results in a credit to the unpaid balance of the service fee line. If the IPYMT includes Group and Reason codes, these codes are nested under the applicable IPYMT line item.
  • The activity code for a claim is CLAIM-E/CLAIM-P and represents the submission of a claim to a payer for a related service fee (SVCFE). While the claim is a request for payment from a payer, this transaction does not have a direct impact on the balance of its related SVCFE line item. ONACCT is another example of informational activity. This transaction represents a credit that has been recorded but not yet applied to any particular SVCFE line item.


The following example shows the activity detail for a service fee line item:

The activity detail shows the service fee (SVCFE) of a procedure, the claim (CLAIM-E/CLAIM-P) submitted to the payer, two types of payments that were recorded: guarantor (GPYMT) and insurance (IPYMT), and the balance (BALANCE) as a result of these transactions. Notice that the SVCFE entry is the parent activity code to the claim and payments. These activity codes are nested beneath the service fee line item.

All other transactions are listed under its parent service fee line item, for example, miscellaneous adjustments. This activity type can be either the MADJN or MADJP activity code and is recorded based on the negative or positive affect the adjustment has on the account. These activity codes have unique transaction codes that specify the adjustment activity and its effect on the account.

If a referring physician has been recorded on the case, the name of the referring physician will also be listed in the details of the service fee (SVCFE) line.

How to Get Here?

From the Home Page:From the Menus:Via Shortcut Keys:
  1. Click Accounts from the Manage list.
  2. Search for an account.
  3. Double-click an account to open the Act: [ID] page.
  1. Open the Manage menu and select Accounts.
  2. Search for an account.
  3. Double-click an account to open the Act: [ID] page.
  1. Press [Alt] + [M] + [A].
  2. Search for an account.
  3. Double-click an account to open the Act: [ID] page.

 



Field Definitions

Field

Type

Required

Description

Filter by DOS

Filter

No

To specify and filter the service fee line items by date of service.

To include all service fee line items, clear the date from the field.

Filter by CaseFilterNo

To specify and filter the service fee line items by case.

To include all service fee line items, clear the case from the field.

Show Zero BalancesCheckboxNoTo specify whether service fee line items with zero balances are also displayed in the list. By default, this option is set in Account Preferences.
Show EditsCheckboxNo

If selected, any changes made to payments after they have been posted (allowed modifications to posted payments include changing the Allow/Disallow, CONT WO, Copay, Deduct, WHold, Paid QTY, and Control Number values) are displayed.

If not selected, payments modified after posting are indicated by a symbol.

Show LegendClickable LabelNo

Visual aids help you identify the status of a line item and the party financially responsible for the outstanding balance. Pending line items, entered but not yet posted, are coded in yellow. Balances are color-coded based on financial responsibility. For example, the unpaid balance on an account where a payer is the responsible party is coded in purple. A line item that has been reversed is indicated with  to the left of its label, for example a reversed service fee line.

Opens the legend which helps identify the line item status, responsible party, any special activities that may have occurred on a line item, for example, a reversed payment or service fee line. If the line item is denied, the description of that line item is notated by the strike-through effect.

Date

Display Only

(system-generated)

Yes

The date of the transaction for the line item. This table includes descriptions of how the date is recorded for each activity code.

Activity CodeDescription
BALANCEThe date of the most recent activity on the SVCFE line item.
CLAIMThe date the claim was submitted to the payer.
GPYMTThe date the guarantor payment was posted.
MADJNThe date the adjustment was approved for a SVCFE line item adjustment. For a payment adjustment, the date is blank.
MADJPThe date the adjustment was approved for a SVCFE line item adjustment. For a payment adjustment, the date is blank.
IPYMT

The date the insurance payment was posted. All sub-entries for this activity use the date, for example, COINS (coinsurance), COPAY (copay), DEDUC (deductible), and WHOLD (withhold).

For the CWOFF (contractual write-off sub-entry), the date is the posted date of the parent IPYMT.

For the RCODE (reason code) sub-entry, the date is blank.

ONACCTThe date the on-account transaction was posted.
SVCFEThe date of service for the procedure.
Activity Type

Display Only

(pulled from Case)

Yes

The itemized activity associated with a service fee line item, which represents the billable medical procedure on a case. The SVCFE activity code is the parent to all activity for sub-entries that is recorded on the service fee line item and is a means for grouping this activity. Sub-entries on a service fee line item are recorded as independent activity codes according to the type of activity. Each sub-entry is nested under its parent activity code, as shown in the following example:

This example shows the parent SVCFE line item and sub-entry activities: IPYMT, MADJN, RVSUS.

A BALANCE entry represents the end of the grouping.

Description

Display Only

(system-generated)

Yes

Details of an AR account activity. The first line is the service fee (SVCFE) line item for which the procedure is being billed. The SVCFE code indicates the parent of a single billable item on a case. Transaction activity recorded on the service fee line item is indented, as shown in the following example:

Patient

Display Only

(pulled from Case)

YesThe name of the patient who received treatment on the case.
Amount

Display Only

(pulled from Case)

Yes

The amount billed on the procedure (SVCFE) line item. The following example shows the entries for a procedure billed for one provider:

If the procedure is being billed for multiple providers, this amount will be the calculated split amount and listed on separate SVCFE line items. If the payer is configured to allow charges for multiple providers to be billed on separate claims, individual SVCFE and CLAIM line items will be created for each claim.

The following example shows a 50/50 split between two providers billed on the same claim:

Balance

Display Only

(system-calculated)

Yes

The unpaid balance on the SVCFE line item or the credit balance on the ONACCT line item. The balance is color-coded based on financial responsibility. The following key shows the color coding:

OptionDescription
GuarantorApplies to the unpaid balance for which the guarantor is responsible.
Credit BalanceApplies to the ONACCT activity code for which a payment has been received from a guarantor for a service fee that has not yet been billed.
Service Line Details Section

Displays case and pre-collections information for a particular service fee line and links to the charge batch and payment batch in which charges and payments were entered. The information is dynamically updated based on the selected.
Provider

Display Only

(pulled from Case)

YesThe name of the provider (and provider's credentials) who performed the procedure.
Facility

Display Only

(pulled from Case)

YesWhere the procedure was performed.
Case

Display Only

(pulled from Case)

YesThe case number of the service fee line.
Charge Batch

Link

(pulled from Charge Batch)

YesThe charge batch in which the charge for the service line was entered. Click the link to view the charge batch.
Payment

Display Only

(pulled from Payment Batch)

NoThe Payment ID of the selected payment.
Payment Batch

Display Only

(pulled from Payment Batch)

NoThe payment batch in which the payment was entered. Click the link to view the payment batch.
Expected Fee

Display Only

(pulled from Case)

YesThe expected fee for the selected service line.
Accounting Date

Display Only

(pulled from Case)

NoThe accounting date entered on the case.
Ins Plan

Link

(pulled from Case)

NoThe insurance plan tied to the service fee line. Click the link to open the Claim Information window.
Pre-Collection File

Display Only

(pulled from Pre-Collections data)

NoPre-collections information (if applicable), including the Start File Case ID and the Start File Created At Date.

Created By

Created At

Posted By

Posted At

Read-onlyYes

Displays the user, date, and time when the transactions were created and posted.

For system-generated transactions, Created By and Posted By are shown as System.

Account Balance

Display Only

(system-calculated)

YesDisplays the sum of the outstanding balances on all service fee lines.
Case Balance

Display Only

(system-calculated)

NoDisplays the current balance on the SVCFE (case).
Case Billed

Display Only

(system-calculated)

NoDisplays the actual amount billed on the case.

Button Descriptions

Button

Shortcut Keys

Description

Step-By-Step Guides

Adjust Line[Alt] + [J]

To apply adjustments on the SVCFE activity code.

Applying Service Line Adjustments
Distribute[Alt] + [D]To apply distributions on the ONACCT activity code.Distributing On-Account Funds
Rebill[Alt] + [R]

To rebill or void a claim on the CLAIM activity code.

A claim can be rebilled as it was originally billed or with changes that do not affect service fees or updated with changes to service lines with or without fee changes.

The CLAIM activity code is updated Cancelled Claim and a new claim is created with the REBILL activity code.

You can click any of the following sub-entries for the SCVFE transaction code:

  • CLAIM-E (electronic claim)
  • REBILL-E (rebilled electronic claim)
  • CLAIM-P (paper claim)
  • REBILL-P (rebilled paper claim)

Rebilling Claims with Fee Changes

Rebilling Claims without Fee Changes

Voiding Claims Sent in Error

Refund[Alt] + [U]To refund a payment on the GPYMT or IPYMT activity code.Refunding Payments
Reverse[Alt] + [E]To reverse a SVCFE (charge), GPYMT, IPYMT RSCND (payment), REFND activity code or MADJN/MADJP (miscellaneous adjustment).

Reversing Charges

Reversing Payments

Reversing Miscellaneous Adjustments

Roll To[Alt] + [T]To reassign the financial responsibility on the SVCFE activity code. This activity is recorded on the Notes tab.Reassigning Financial Responsibility
View Tran[Alt] + [V]

To review a transaction related to the SVCFE, CLAIM, IPYMT, GPYMT, or EPYMT activity codes.

The button is activity once the activity code is selected.

  • For SVCFE, the case details are shown.
  • For CLAIM-E/CLAIM-P, the submitted claim form is shown.
  • For IPYMT, GPYMT, or EPYMT, the payment details are shown.

Viewing Cases

Viewing Claims

Viewing Payments

View Attachment[Alt] + [M]To review the image that is attached to a transaction: SVCFE, CLAIM-E/CLAIM-P, GPYMT, or EPYMT activity codes.Viewing Attached Images
Ext Pending Deny[Alt] + [Y]To deny a SVCFE line item pending for external collections.
  1. Select a SVCFE line item pending for external collections.
  2. Click Ext Pending Deny. The Deny External Collection Transfer window opens.
  3. Enter a Note.
  4. Click OK.
Int[Alt] + [N]To transfer the SVCFE line item to guarantor collections. The service fee line must have an outstanding balance and be in guarantor responsibility.Transferring Service Fee Lines to Internal Collections
Ext[Alt] + [X]To transfer the SVCFE line item to external collections. The service fee line must have an outstanding balance for which the guarantor is financially responsible.Transferring Service Fee Lines to External Collections
Payment Plan[Alt] + [P]

To create a payment plan on the guarantor account with outstanding balances on the SVCFE activity code in guarantor responsibility. If the account has a payment plan, the following text appears across the top of the Active AR tab. A Payment Plan is active for this account.

If a payment plan is active on the account, the SVCFE line item will not be flagged for pre-collections.

Creating Payment Plans
Stop Pre-CollNot applicableTo cancel the pre-collections process on the SVCFE line item. The service fee line item is added to the Pre-Collections Stop file.Canceling Pre-Collections on Service Fee Lines
Suspend Pre-CollNot applicableTo suspend a specific service fee line from qualifying for the pre-collector, even it meets pre-collection criteria. In order to use this function, the service fee line item cannot currently have a Pre-Collections status. This button can also be used to remove the Suspended status.Suspending Pre-Collections Eligibility Status on a Specific Service Fee Line
Hold Statement[Alt] + [H]To prevent paper statements from being sent to the guarantor. Hold statements on a particular service fee line or any service fee line paired with a specific date of service.Holding Statements on Specific Service Fee Lines
Print Claim Remit[Alt] + [L]To generate the Remit Detail report which mimics the information presented on the Claim Detail tab of the Medicare Remit Easy Print software. This option lists the claim detail for all Electronic Remittance Advice (ERA) service line transactions rolled into a single payment.Generating the Remit Detail Report
Print Activity[Alt] + [I]To print the account details filtered by outstanding balances and date of service, case, or both.Printing the Account AR Activity
Print Overview[Alt] + [O]To generate an Account Overview Report detailing charges, payments, refunds, adjustments, aging, billing history, notes, and guarantor collections. This report is generated in PDF format (.pdf) and may be printed or saved to your hard drive.Generating the Account Overview Report


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