You have the ability to apply a Self-Pay percentage discount using the Statement Profile to define how you want it to work.
- Transaction code, SPD (Self-Pay Discount) is System delivered by default, but you can create one of your own if you prefer.
- 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 the balance on all Statements.
- 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.
Examples of "First Statement Only"
- 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.
- If a Guarantor has one Encounter that has been sent on a Statement and one that has not, the discount will not be applied.
- 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.
This is how the Self-Pay Discount should be set up.
- Code: SPADJ (or one that you prefer)
- Type: Credit
- Group: WP
- Description: Self Pay Discount
- Abbreviation: SPADJ (or one that you prefer)
- Responsibility: Choose Patient Only
- Report As: Adjustment
- Select Save [F2].
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