Financial Class
A Financial Class is a categorization of Payers that groups them by similar billing rules to streamline claims processing and reporting.
- Many Legacy Systems add the Financial Class as a field on the Patient record.
- This can be translated to the PM by adding an Insurance Profile (using Insurance Management) to the Patient.
- The Insurance will have the Financial Class designation instead of the Patient.
Reporting Groups can be used to designate and report on Financial Class by Insurance.
- Set up the Insurance Library to support Financial Classes using Reporting Groups.
- Add the Insurance to the appropriate Patient(s) using Insurance Management.
- Use the Reporting Group on the Insurance to include Financial Classes on Reports.
Financial Class Setup
Insurance Library Setup
Create separate Insurances in the Insurance Library for each associated Financial Class, and then add the corresponding Reporting Group to the Insurance.
- Example: Create Insurances for Aetna Medicare, Aetna Commercial, and Aetna HMO.
- For Aetna Medicare, set the Reporting Group as Medicare.
- For Aetna Commercial, set the Reporting Group as Commercial.
- For Aetna HMO, set the Reporting Group as HMO.
Learn More: Add or Modify Insurances in the Insurance Library
Insurance Management Setup
Add an Insurance Profile to the Patient (using Insurance Management) with the Insurances created above.
- Example: A Patient has Aetna HMO.
- In Insurance Management, add the Insurance Aetna HMO as the Primary Insurance to the Insurance Profile.
Learn More: Insurance Management
Include Financial Class on Reports
Using a Reporting Group to designate a Financial Class allows you to include Financial Class on reports.
- On standard Reports (not Queries), use the Insurance Reporting Group filter.
- On Queries (such as the Custom Encounter Query), use the Insurance Reporting Group filter, or add the Insurance Reporting Group column to include the Financial Class in the Query output.
Learn More
Add/Modify a Reporting Group
Use Reporting Groups
Insurance Management
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