Self Pay Profile

Self Pay Profile


Self-Pay Profile

The Guarantor is the Responsible Party for all balances that are in the status of Patient Responsibility. The System defaults to Self Pay when there is no Insurance Profile.

  • The Self-Pay Profile is System delivered, which makes it unnecessary to set it up in the Insurance Library.


Two Types of Patient Responsibility

  • Self Pay: Patient does not have Insurance. The system assigns Self Pay automatically if no Insurance is chosen on Patient Registration. A Self Pay Charge does not have a Claim Status because it will never go to an Insurance.
  • Self Pay after Insurance: The remaining Balance drops to the Patient after Insurance has paid.


Move an Encounter to a Self-Pay Profile from an Insurance Profile

In an Open Period

The ability to move an Encounter from a Profile with Insurance to a Self Pay Profile in an Open Period can be done on the Modify Charge screen.

If there is a Self Pay Profile select Self Pay from the dropdown on the Modify Charge screen.

  1. Select the Modify button on the Encounter Dashboard.
  2. From the Insurance dropdown menu, select Self Pay.
  • You may get a Validation Warning that the Fee will change.

  1. Select Save [F2].

If a Self Pay Profile does not exist in the Insurance dropdown, it will need to be added to the Insurance Management Screen.

  1. Select the Insurance Management link on the Patient Dashboard.
  2. Select the Add Self Pay Profile.
  • If Self Pay is already a Profile, the Add Self Pay Profile button will not be available.


In a Closed Period

If the Encounter is in a Closed Period, the Insurance field on the Modify Charge screen will be grayed out.

  • When the Profile is changed to Self Pay, the Encounter is reversed.
  • A positive charge Encounter and negative charge Encounter will be created.
  • The original Encounter number remains the same and changes can be made to it.


Move the Closed Period Encounter to Self Pay

  1. Select Insurance Management on the Encounter Dashboard or on the Modify Charge screen.
  2. Use the Add Self Pay Profile button to create the Self Pay Profile if there is not one.
  3. Select the Profile line that contains the Encounters you want to move. (The line will be highlighted.)
  4. From the list at the bottom of the screen, select the checkbox beside each Encounter number that needs to be moved to Self Pay.
  5. Select Change Profile/Rebill.
  6. From Current Profile - To New Profile: Select Self Pay.
  7. Rebill: Leave checked. This will automatically set the Encounter to be billed to the Patient.
  8. Select Save [F2].



Learn More

Self pay Validation Warning





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