Manage Financial Responsibility at the Visit Level

This workflow enables you to make updates to guarantor and insurance information for a patient.

Check In Patient

Financial Responsibility is displayed as an incomplete task during check-in if insurance is not allocated. See Check In an Appointment.

From the Check In Summary, select the incomplete task for Encounter Missing Information.

Note:

If the patient's age is greater than the self-determination age, or if the patient is an emancipated minor, the patient is added as a guarantor the first time Financial Responsibility is opened for the patient.

Add Guarantor

To add a guarantor:
  1. Select Add Guarantor.
  2. Search for the person by name or other search criteria.
  3. If the person is found, select the person, select the relationship, then select Add.
  4. If the person is not found, select + Add New Guarantor, select the relationship, complete any additional fields, then select Add. The guarantor is added to the system as a person.

Add Insurance

To add insurance:
  1. Select Add Insurance.
  2. If the patient is the subscriber, complete insurance information, then select Add. The insurance is displayed as allocated in Financial Responsibility. Continue to Step 9.
  3. If the patient is not the subscriber, clear Self Subscribed.
  4. Complete the insurance information, then select Next.
  5. Search for the subscriber by entering a name or other search criteria.
  6. If the person is found, select the person, select the relationship, then select Add. The insurance is displayed as allocated in Financial Responsibility. Continue to Step 9.
  7. If the person is not found, select + Add New Subscriber.
  8. Select the relationship, complete any additional information, then select Add. The subscriber is added to the system as a person and the insurance is automatically allocated and displayed in both the Active and All tabs in Financial Responsibility.
  9. Return to the Check In Summary to continue the check-in workflow.

Allocate Insurance

To allocate insurance for a patient visit, select Actions (…) for the appropriate insurance and select Allocate. To deallocate insurance, select Actions (…) and select Deallocate.

Prioritize and Sequence Insurance

To prioritize and sequence allocated insurance:
  1. Under Insurance, select Allocated to display only allocated insurance for the patient.
  2. Select Actions (…) for an insurance and select Move Up or Move Down. You can prioritize and sequence only allocated insurance. Insurances must be filtered by Allocated.

Manage Insurance

  • To update insurance information, select Actions (…) and select Edit for the applicable insurance. Select Save to save any updates.
  • For allocated insurance, select Actions (…) and select Verification to view verification details for the insurance. Select the Verified checkbox, enter applicable notes, and select Save.
  • A Needs Attention task is displayed for any insurance allocated for a visit that is not verified.

Check Eligibility

To check eligibility, select the appropriate insurance and then Check Eligibility. See Check Eligibility for more information.

Review Patient Bill Estimates

You can review the estimate for a patient's out-of-pocket costs for a visit. See Review Patient Bill Estimates for more information.