Apply a Self-Pay Discount automatically using the Statement Profile

You have the ability to apply a Self-Pay percentage discount using the Statement Profile to define how you want it to work.

• Self-Pay Transaction Code

• Transaction code, SPD (Self-Pay Discount) is System delivered by default.

• If the First Statement Only checkbox is selected, a discount will be applied to the Charge amount on the First Statement. This gives the Guarantor the incentive to pay in full before the second Statement is sent.

• The discount will be applied to the Charge amount on the First Statement Only.
• If the Encounter has been billed already, the discount will not apply.
• If the Balance is not paid in full on the first Statement, the discount will be reversed when the second Statement is generated using the same Self-Pay Transaction Code.

• If First Statement Only is unchecked, the discount will be applied to Encounters that are attached to Self-Pay Profile in Insurance Management.

• The Self-Pay Discount will be applied when the Encounter(s) first appear on a Statement.
• The Discount will be applied once and will remain on future Statements that contain the Encounter(s).

• The discount rate will show on the Statements and in POPs.

• Charge Lines that are entered as Billable = Patient will be treated as SELF-PAY even if they are not on a Self-Pay Profile.

• Items that are to be billed directly to the Patient (by-passing insurance) can be entered on Charges that have Procedures that are to be billed to an Insurance. Set the Billable option to Patient for the items that should be billed directly to the Patient. Charge lines where Billable is set to Patient will be eligible for the SELF-PAY discount.

• Example: Encounter 123 has a Charge of $125, which is Self-Pay and will produce a Self-Pay discount of 20%.

• When the Statement is created, the Self-Pay discount for 20% will be taken.

• The discounted balance is $75.00.

• The Patient Pays $25 of the $75.00 balance.

• The next Statement will be billed with the amount of $50.

• The discount has already been taken and is not taken a second time.
  

Examples of "First Statement Only"

1. If a Guarantor has paid their account in full, and then the Patient has another Encounter that has not been billed on a Statement yet, the discount will be applied.
2. If a Guarantor has one Encounter that has been sent on a Statement and one that has not, the discount will not be applied.
3. If the Guarantor is on a Payment Plan, a discount will not be applied.

Apply a Self-Pay Discount Manually

To apply a discount manually, use the System delivered Transaction Code, SPD, or add a Custom Adjustment code. You can report on this Adjustment Code for tracking purposes.

• On the Encounter, select the Adjustment link.
• Select the Transaction Code.
• Enter the Adjustment amount.
• Select Save [F2].

If you want to add a different Transaction Code for tracking, you can create your own in the Transaction Code Library. An example of this would be that you may want to distinguish the System Adjustment from an adjustment done manually.

Self-Pay Discount Transaction Code Setup

1. Code: SPADJ (or one that you prefer)
2. Type: Credit
3. Group: WP (Write-off Patient)
4. Description: Self Pay Discount Done Manually
5. Abbreviation: SPADJ (or one that you prefer)

• Used on Reports and on screens with limited space.

6. Background Color and Text Color: Coming soon.
7. Responsibility: Select Patient Only.
8. Display on Statement: If you want this Transaction Code to display on Statements, select Patient.
9. Statement Description: The description you want to display on the Statement.
10. Provider: Select a Provider if this Code is only applicable to one Provider.
11. Report As: Adjustment
12. Active, Significant, and Mass Write-off: Select if applicable.
13. Select Save [F2].

Learn More

• Payment Rules: Self Pay Discount on Statement Profile Setup
  

• Transaction Code Library

• Post an Adjustment