Clients with Patient Liability are responsible for paying the provider directly for a portion of the cost of waiver services each month. The amount of this liability must be entered for each client on the Client Information screen (Basic Information section):
For billing, clients with Patient Liability will not be included in the standard invoice flat file. A separate invoice flat file is used for all Patient Liability clients. To create this separate invoice flat file, follow these steps:
- Set the date span. This can be any span of dates. All previous "locked" billing in the current month will be included in the new invoice.
- Select the client. Each invoice is "per client".
- Set the Patient Liability checkbox.
- Unlock any records you want included in the "rebill".
- Click the 'Invoice' button.
The start and end date filters should be set from the first of the month to the end of the billing cycle. Billing data that has had a rate change AND billing data that has had PL taken out will automatically be unlocked and all PL billing will be recalculated for the entire month. This accounts for any changes that might have occurred in the rates for previously billed data. All billing data that matches what was previously billed after recalculation will not be included in the invoice flat file, and will be locked. That way, only billing data that has changed or added new will be invoiced.
If the you find that the transmission flat file does not include the PL billing records as you expect, it's because those records were previously billed. You can re-bill these by following these steps:
1. Unlock the billing records you want to re-bill from the Reconciliation screen.
2. Delete those billing records.
3. Re-create the billing records (Create Billing). Be sure you have the filter for the PL client and the PL checkbox set.
When you run the invoice, those billing records should be included in the transmission flat file.
The three 'Billing Total' fields are calculated using the logic:
Total Setup Billing
All billing data including the Patient Liability.
All billing data less the Patient Liability.
Total to be Billed
All unlocked billing data. This may not match exactly with the actual invoice flat file if the Patient Liability has not yet been met for the month.