Insurance Discounts

[Jubilee]

So using lovely Officemate, it seems I currently have two options to deal with my insurance mandated discounts... I can either "bill" them to the insurance, or I can "discount" it after applying insurance.

Right now we are inconsistent and I am not sure if there is a benefit to doing it one way or the other, except for consistency's sake.

With funded materials/services, the discounted amount gets written off when the funded portion is applied. However with CL Evals, discount only plans, etc, I have one optician that will discount them through the discount function, and another who bills it to insurance.

Part of me really likes the idea of knowing an exact amount a particular insurance affects our revenue. So the bill to insurance would be the preferable method to me, and that way I can say we only get a 30% on Davis, and be pretty darn close in that calculation.

However that is a lot of line item adjusting in Officemate, and there is that old saying "time is money!"

I know sometimes if can affect taxes, depending upon accounting method being used, and the accountant..

Thoughts?

[DanLiv]

Lumping write-off and discounts together may give you a simpler bottom line for seeing what is "lost" due to insurance (is it really lost? Only if that patient would have come to you and paid full price without the insurance), but it also makes it impossible to distinguish the two and does make for more adjustments and write-offs when the checks come in. I use Officemate too and only bill funded benefits and discount others. If there is a guaranteed zero payment coming from the insurance (like 20% off frame overage), it seems unproductive to bill fees to the insurance just to be revisited and written off later. Especially so with purely discounted services. If there will be no reconciliation with insurance payments necessary, just discount it and be done with it. Plus separating billables and discounts makes the fee slips more accurately reflect what is actually going on, e.g. if a $200 frame has $130 billed to insurance and an additional 20% discount someone looking back at the fee slip can very easily decipher what was done to reach the final cost, rather than simply billing a lump $144 to the insurance.

[AngeHamm]

Lumping write-off and discounts together may give you a simpler bottom line for seeing what is "lost" due to insurance (is it really lost? Only if that patient would have come to you and paid full price without the insurance), but it also makes it impossible to distinguish the two and does make for more adjustments and write-offs when the checks come in. I use Officemate too and only bill funded benefits and discount others. If there is a guaranteed zero payment coming from the insurance (like 20% off frame overage), it seems unproductive to bill fees to the insurance just to be revisited and written off later. Especially so with purely discounted services. If there will be no reconciliation with insurance payments necessary, just discount it and be done with it. Plus separating billables and discounts makes the fee slips more accurately reflect what is actually going on, e.g. if a $200 frame has $130 billed to insurance and an additional 20% discount someone looking back at the fee slip can very easily decipher what was done to reach the final cost, rather than simply billing a lump $144 to the insurance.

This, exactly.

[Jubilee]

Of course, if the receipts were decent enough for any patient to follow, it would help ;) I can't tell you how many times I get patients asking if I could make those easier to follow.

[AngeHamm]

Of course, if the receipts were decent enough for any patient to follow, it would help ;) I can't tell you how many times I get patients asking if I could make those easier to follow.

Be careful what you wish for. OM's receipts are downright simple compared to the chaos of Revolution's.

[Caroline]

If you can add another insurance to Office Mate, maybe add "EyeMed Discount Plan" or something to differentiate them in your system.

[Jubilee]

I do have discount plan listed as an option in the plans for Eyemed. We seem to have a fair amount of plans that cover exam, but then the mats are straight up discount.

I wished that OM allowed me to customize that receipt.. the way you can with some of the letters, recalls, etc.

[Renee Jalbert]

The problem I find with OfficeMate, as stated in the original post of this thread, is that different people in the office doing the same job are doing it two different ways. I have had more trouble just getting those who check patients out and enter those charges to do it the same way than I have with anything else! If it were just one person it might not be so tough, but we cannot reduce to that any longer with the patient load we now have. I find that I have to police the entries now more than ever, and talk about "Time is money!" Mine is completely wasted and no matter what I say or do, I cannot get it to change. I prefer the method that DanLiv mentioned and wish my world worked that way!

[colem84]

When I enter an order through OM, I'll bill whatever the patient is to pay to the insurance, if they have any. If it's a discount only plan, then I'll use the discount feature and put the amount/percentage off. Sometimes if I place an order on hold and the girl at checkout goes to put the exam information on the fee slip, it'll delete my discount. We haven't figured out why it does that, though.

[DanLiv]

Sometimes if I place an order on hold and the girl at checkout goes to put the exam information on the fee slip, it'll delete my discount. We haven't figured out why it does that, though.

Yes I HATE that and cannot figure any benefit to it. It's intentional as it warns you that certain changes will reset the fee slip. OM, why would I want the fee slip reset, and why especially allow it to reset at the hands of someone who might not know how to properly restructure it!? And if it could come in handy, how about just adding a "reset fee slip" button and stop doing it automatically!? I should stop... I will wear my fingers to the bone proclaiming all my irritations with OM.

[Jubilee]

Is it bad that I was tempted to take a summer workshop on creating an open source EHR? I tried to get the kid to take it, instead of the Unreal4 Engine one, but no dice...


Building an Open-Source Medical Records Platform

June 22-26
Faculty: Saptarshi Purkayastha, Ph.D.
This workshop is aimed at providing students with the tools and introductory knowledge to be able to participate in open source projects. In this workshop, students will learn to work with tools to build electronic medical record systems by participating in the free and open-source OpenMRS community. OpenMRS is a worldwide network of volunteers from many different backgrounds including technology, healthcare, and international development, who come together to improve health care delivery in resource-constrained environments to create and support this software.
Based on curriculum with Openhatch. Participants will learn tools so they can participate in contests like Google code-in.

[Johns]

Is it bad that I was tempted to take a summer workshop on creating an open source EHR? I tried to get the kid to take it, instead of the Unreal4 Engine one, but no dice...


Building an Open-Source Medical Records Platform

June 22-26
Faculty: Saptarshi Purkayastha, Ph.D.
This workshop is aimed at providing students with the tools and introductory knowledge to be able to participate in open source projects. In this workshop, students will learn to work with tools to build electronic medical record systems by participating in the free and open-source OpenMRS community. OpenMRS is a worldwide network of volunteers from many different backgrounds including technology, healthcare, and international development, who come together to improve health care delivery in resource-constrained environments to create and support this software.
Based on curriculum with Openhatch. Participants will learn tools so they can participate in contests like Google code-in.

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Interesting course...