The Service Entry screen is a flexible tool that allows a user to quickly and conveniently record billable/non-billable encounter information that occurred with a consumer such as therapy, treatment, consultation, phone calls, etc. Services can be entered as daily, weekly, in multiples or individually. Units, elapsed time and “incident-to” information are some of the things that can be captured on this screen. Users can also enter non-consumer related services such as documentation time through this screen. Once an encounter is entered, the system allows the user to edit the services if errors were made or process the entry for billing purposes.

Begin by selecting Service Entry from the Clinical section of the Main Menu.

The screen will display the tabs associated with Service Entry along with the fields needed to enter the encounter information.

Common Features of the Service Entry Screen

Some of the features on the Service Entry screen will be used for all variations of entering encounter data. These features are used to make data entry go quickly and efficiently.

Set Records Button

Users can enter single/multiple services for single or multiple consumers. The Set Records button allows the user to inform the system of the number of records they wish to enter at the time of data entry without having to enter each service individually.

The system always shows one entry the first time the user enters this screen. If a number is entered and the Set Records button is clicked, the screen will refresh with the desired number of rows displayed.

Setting Common Data

Setting common data is the ability to enter common information in the top section of the Service Entry screen that will populate the lower records. If you want the Consumer, Provider, Facility, etc. to be the same in all the entered records, this feature should be used.

Enter data for the desired common fields in the lookup section at the top of the screen.

When all common data has been entered, click the Set Data button at the top of the screen. The system will populate all records with this data.

Users can change data in any field after the records are returned. Simply highlight the incorrect text and type the new information.

Ignore Row Checkbox

This feature is useful if one record is invalid but the rest continue to be valid. Users can continue to add services for the valid records without having to stop and research the invalid record or start the process over. The invalid record can then be added at a later time

Click the Ignore Row checkbox to ignore an entry.

Adding One More Record

If a user has completed entering encounter information and decides that they need to add another record to the system they can do this easily. Clicking on the One More Record button will refresh the screen with one additional record where users can follow the same procedures for data entry as with all other records.

If multiple records were entered with common data, the new record will contain the common data established at the top of the screen.

Range Entry Button

When this button is selected in a returned record for an individual service, another adjacent field appears and the user can enter in an end date for the service. The system will then add that same service for each day included in the overall date range.

Error Messages

ShareCare searches for various errors on service entry records in two ways, once while data supporting the service is entered, and then while an actual service is being added. Examples of the first type include errors involving services that aren’t available at specific facility/program combinations or providers that aren’t authorized for a particular facility. For instance, if a user specifies a particular facility, only those programs and services authorized for that facility could be entered in the record. The system also checks for different types of errors at the time when the user adds the entry to the system. Examples include, admissions, authorizations and contracts. The system displays the error messages in two different ways. First, with pop boxes and second with red messages in the actual record.

Example of a pop up error message:

Example of a red error message:

Some red error messages will allow the user to continue entering the service to the system with the errors; others will not allow the user to continue unless the error is corrected.

Duplicate Checks

To prevent billing the same service more than once, ShareCare performs a duplicate check during service entry. A Global Variable is specified during implementation that allows system administrators to determine which data elements they wish checked during the duplicate check process. If a record matches the duplicate check criteria, the user will receive a duplicate record warning. The service entry record will have to be updated in order for the system to accept the record.

Adding an Admission through Service Entry

Users will be able to add an admission through the Service Entry screen if a consumer received services prior to being admitted in ShareCare.

If the consumer does not have an admission, an error message will be returned at the top of the record with a blue hyperlink.

Clicking on the Click here hyperlink will open an admission record. The system will automatically populate some of the fields with data from the Service Entry screen. Enter the remaining optional and required data and click the Add button. The system will return the user to the Service Entry screen where the user can try to add the service again.

Who can add an Admission via the Service Entry screen?

Only those users who are authorized to add admissions to consumer records will be able to access the Admission screen from the Service Entry screen. The Admission error will still display on the Service Entry screen, along with the Admission hyperlink. However, when users who are not authorized to add admissions select the hyperlink, an error will appear when the Admission screen displays indicating that the user is not authorized to view the screen and that person will not be able to proceed with entering the admission.

Single Service Entry

The Single Service Entry option is used to enter encounter information for one consumer for one incident of a particular service. This would typically be used immediately after a provider has seen a consumer and needs to enter the encounter information and progress note.

When the user enters the Service Entry screen the system will display one record and the common data entry section.

Type the required information in the blue fields and any other optional information in the remaining fields. When all information has been entered, click the Add button.

If no errors were located in the entry the system will add the service to the consumer record allowing it to be billed to Payor sources. Users may then have the option to add a Progress Note that will be attached to this service. Please see the Progress Notes documentation for instructions on this process. If a user selected to add the entry with errors they will receive an error message.

Click Yes if you wish to continue, click No to return to a blank record and start over.

Multiple Service Entry

The Multiple Service Entry process allows the user to enter various services for one or more than one consumer, for the same or different service, facility, provider, and/or program on the same data entry screen.

When arriving at the Service Entry screen, enter the number of records that you would like to add in the Number of Records to Enter field. Users can enter a minimum of one record and a maximum of ninety-nine. Click the Set Records button.

The system will return the desired number of records.

Enter the information that is common for all entries in the common data entry section and click the Set Data button.

The user can add additional common elements to the fields by entering them in the common data entry section and clicking on the Set Data button again.

Enter the uncommon data that is specific to the various records on the screen and click the Add button to add the records to the system.

If the entry was successful the user may be asked to enter a Progress Note. Please see the Progress Note documentation to do this.

Batch Service Entry

The Batch Service Entry process allows the user to enter several incidents of the same service for a single consumer over a given time range. This method is useful for services provided on a weekly or daily basis. Users can enter the service on a time span calendar when in the Batch Entry mode and submit all records for a week or more at one time.

When arriving at the Service Entry screen, click the Batch Entry button at the top of the screen.

The Batch Entry: screen will display. Services can be entered here on the calendar format. The calendar will list a month with weekends color-coded in gray. The encounter information fields will also appear.

Select the month and year that you prefer and click on the Set Dates button. The dates pertaining to the month you selected will display.

Enter the number of units in the date field(s) when the service was performed. If the number of units is the same for every day, enter the unit value in the Set Day Values field and click the Set Day Values button.

The system will automatically enter the number of units in each date field if the Set Day Values feature was utilized.

Highlighting the data in the field and selecting the Delete button on the keyboard can delete any day value. Click on the Exclude Weekends checkbox if you want to prevent units from displaying within all weekend dates.

Enter service data in the fields in the lower section of the screen. Be certain to enter the required fields or the system will not save the record. Required fields include Consumer Name/ID, Provider Name/ID, Facility Name/ID, Program Name/ID, and Service/Code.

Click the Add button to save the data to the system.

The service and the number of units will be entered for each day selected on the calendar for the given consumer.

If the entry was successful the user may be asked to enter a Progress Note. Please see the Progress Note documentation to do this.

Billing

The billing cycle in ShareCare begins with a service entry and finishes when a bill has been printed. In between these functions are the service selection, where users determine the services to bill; billing calculations, which determine the outcome of the billing process; billing run review, in which users can review other areas of the system to confirm that the billing run was complete; and billing run acceptance, where the billing run can either be committed permanently or deleted. These steps of the billing cycle are explained in detail in this potion of the manual.

Begin by selecting Billing from the Fiscal section of the Main Menu.

The system will display the Billing tab and other associated tabs.

Billing Status Report

The Billing Status Report must be run/created to review all services that are applicable to the billing criteria selected. By running the report, users can view those services that contain errors that will prevent the service from being billed and also see the services that are accurate and billable. After the report is viewed, the decision can be made to either proceed with the billing run, in which case the services that contain errors will not be billed, or to correct the errors within other areas of the system and return to the Billing screen at a later time to proceed with billing once all errors have been addressed.

To run the Billing Status Report (BSR), check the box next to Billing Status Report Only (No Invoices Created).

Select the criteria for which you would like to filter the report. The report can be specified to list all services, only billable services or only un-billable services as well as any that have been excluded from being billed due to Exclusion Stop Rules.

Identify the services that are to be viewed. The services can be filtered/viewed for a specific Consumer, Guarantor, Organization, Facility, Program, Payor group, Payor plan or Provider. Enter the date range in which the services should be billed.

Services can be filtered by date range alone. The system does not require any other criteria. It is important to mention that the fewer criterions that are entered the longer the system will take to run the report.

When all criteria have been selected, click the Process button to view the report.

The system will inform the user that it is processing the request. It may take a few minutes to generate the report based on the selected criteria. The system will inform the user of what it found.

Click the View button to see the Billing Status Report.

Share Care will display the report.

Why is it taking so long to generate the report?

If someone else on the system attempted to run billing or to generate a Billing Status Report just before or simultaneously as you, and his or her job has not completed, it may take some time for the Billing Status Report to generate. The system will perform each billing run or status report in the order in which they are submitted.

For each service, data pertaining to the column headers may be listed: Consumer Service ID, Service Date, Consumer, Guarantor, Payor, Facility, Provider, Service Code, Procedure Code, Total Charge, Warning, Status, Admission ID, Program and/or User. The default for the columns displayed in the report is based on the last billing run. However, users can select which elements they want to appear or remove on the current report by putting/removing a checkmark next to the corresponding column headings and then clicking the Show Fields button.

Sort the data under each heading by clicking on the corresponding blue hyperlink. Clicking on it the first time will display the information in ascending order. Clicking it again will display the information in descending order.

The font of the report can be changed to display more or less information on the screen or to make the report easier to read. To change the font simply select a value from the Display Font Size dropdown and the system will apply the font to the screen.

After all services are reviewed, users may delete the report and return to other screens in the system to resolve the errors that were detailed on the report before performing billing or they can choose to proceed with billing. Any services marked as un-billable will remain un-billable until the errors that they contain are rectified and billing of the services is re-performed.

Click the Delete button. This will close the report and return the user to the initial Billing screen.

Until a Billing Status Report is deleted, it will always appear when the Billing screen is accessed. The same version of the report that was originally displayed will be listed. The report will not be updated with changes that have occurred in the system.

To refresh the report’s data, click the View button to open the report. Click the Refresh button to view the changes in the report.

Refreshing the screen will cause the billing process to re-run and to re-process all of the services that were listed on the initial report. The system will warn the user of this and will indicate that this process may take some time. Users may choose to continue by clicking on Ok or cancel the refresh by clicking the Cancel button.

Once the report is refreshed, those services that previously contained errors that have since been rectified will appear as billable.

Billing Run Creation

The second step of the Billing process in ShareCare is to create a Billing Run. You will use the Billing Status Report to do this. Doing this will save time as you will not have to remember what criteria you had selected or print out the Billing Status Report. The broader the search criteria entered in the Billing Status Report, the more records are going to be processed and the longer billing will take. Because large billing runs may affect the performance speed of the system, users may wish to perform billing after hours or only on designated days/times.

After you have looked at the Billing Status Report and are ready to create the Billing Run, click the Commit button.

The system will display a pop up box asking the user if they are sure they want to Commit this run. Click Ok to process the run, click Cancel to return to the Billing Status Report.

Enter the name of the Billing Run in the Explorer User Prompt box that displays on the screen. Click Ok to process the Run.

How do I name a billing run?

Naming a billing run “Master Ins Plan Jan 2001” or “Donna Coates Dec 2001” provides an easy way to discern what the run contains. For example, “Donna Coates Dec 2001” contains bills for that consumer during the specified month. “Allen Arbor Facility Medicaid June 2001” would contain bills for all consumers that received services at the Allen Arbor Facility during the month of June and have Medicaid Insurance.

The system will inform the user that it is processing the request. It may take a few minutes to generate the report based on the selected criteria. The system will inform the user of what it found.

As the billing calculations are completed, the system creates a transaction for each service, noting all charges, expected to pay amounts and adjustments. The system will group all applicable transactions together into an invoice. Separate invoices will be created for those services provided to different consumers, rendered at different facilities, billed to different payor sources, and containing different external or “other” authorization numbers. Therefore, depending on a consumer’s coverage and treatment, various invoices for each consumer could be generated during a single billing run. These invoices are utilized during the Batch Bill Print function when bills and claims can be printed and/or electronically generated for submission to payor plans. The invoices indicate the services and related charges that should be included on each bill or claim.

Click the View button to proceed to the next step.

Share Care displays information regarding the status of the recently created run.

Notice the Invoice(s) that have been created. At this stage this run has not been committed. It can be deleted and the associated services will go back into the pool of un-billed services.

To continue with the billing process and commit this billing run, click on the Billing Run hyperlink.

The statistics of the billing run will display on the screen.

Review the information for accuracy and click the Commit button to permanently mark the services as billed.

The system will confirm with the user that committing the run is really what they want to do.

Click Ok to commit. Click Cancel to return to the billing screen and start over.

The status field on the run statistics page will then change from TRIAL RUN to COMMITTED RUN.

The billing run is now ready to be printed.

Users can delete a billing run by clicking on the Delete button.

A warning message will display, asking the user to confirm that they wish to delete the run and return all related services to their pre-billed status.

Bill Printing

After a billing run is completed and committed, users can go to the Batch Bill Printing screen to generate bills and claims that can be submitted to payors for payment.

Printing bills in ShareCare is a separate function from entering services and billing calculations. By separating the bill print process, users can run billing calculations more frequently to check for errors and correct them before actually printing the bills and claims. Bill Printing in ShareCare refers to both hardcopy and electronic formats. ShareCare accommodates the following formats: Flat Files, UB-92’s, HCFA 1500’s and 837P along with various state specific formats.

To begin the process of printing bills, select the Batch Bill Print tab.

Select the Bill Format that is to be created from the list of options in the Select Bill Format list.

After the bill format has been selected, click the Next button to continue with the printing process.

Share Care will provide the user with a list of search criteria to sort bills for printing.

Users can print bills based on a committed billing run name, a particular invoice or for a particular consumer or any other combination of criteria.

Enter a date range and a name for the Batch Bill Print Run in the Bill Print Run Name field.

How do I name a Bill Print Run?

Naming a Bill Print Run “Master Ins Plan Jan 2001” or “Donna Coates Dec 2001” provides an easy way to discern what the print run contains. For example, “Donna Coates Dec 2001” contains invoices for that consumer during the specified month. “Allen Arbor Facility Medicaid June 2001” would contain invoices for all consumers that received services at the Allen Arbor Facility during the month of June and have Medicaid Insurance.

Click the Search button to proceed to the next step in the printing process.

The system will return the invoices that can be printed based on the selected criteria.

Review the information for accuracy. To create the billing format that was selected and to create the Bill Print Status Report click the Process button.

The screen will refresh and two hyperlinks will appear at the bottom of the screen, the Bill Print Status Report and Previously Generated Output.

Click on the View hyperlink to review the Bill Print Status Report.

The report will display Warnings and Errors associated with the invoices on the Bill Print Run and with each transaction on the invoice.

When finished reviewing the report, click the Close button.

Click on the Previously Generated Output hyperlink to look at the billing format that was generated during the Bill Print Run.

User can print or download the output file as needed for each Bill Print Run.

Guarantor Statements

The Guarantor Statement in ShareCare is a easy to use feature that allows an organization to create statements for it’s consumers. The Guarantor Statement is used to inform the consumer of what services have been billed to what pay sources, any payments to their account and any outstanding balances. To create a Guarantor Statement in ShareCare you will need to access the Batch Bill Print Functionality.

Begin by selecting Billing from the Fiscal section of the Main Menu.

Once you have entered the billing area, select the Batch Bill Print tab.

Select Guarantor Statement from the Bill Format option list and then click the Next button at the top of the screen.

The screen will refresh with the search options for generating Guarantor Statements.

Enter an End Date and a Print Run Name. Users must also select an Entity, Organization, or Facility. Click the Search button when all data has been entered.

Why must an end date be entered?

The End Date field represents the Invoice Date that you wish to run Guarantor Statements through, any invoices created after this date will not be included in the Bill Print Run you create.

After you have clicked the Search button the Bill Print process will begin and generate a Bill Print Run based on the parameters selected. Once the Bill Print Run is generated, the screen will refresh and provide basic job statistics about the Bill Print Run.

Formatting of the Guarantor Statement can be done at the time the statement(s) are generated. This information relates to the messages that can appear on the Guarantor Statement. Users select whether or not to display print run messages, conditional messages, and global messages on the Guarantor Statement.

Click the Process button to create a Bill Print Status Report and a test file of the Guarantor Statement(s).

Why should I create a test Guarantor Statement file?

It is strongly recommended that you create a Bill Print Status Report and a test file of the Guarantor Statement before creating a production version of the Guarantor Statement. This will allow you to check for errors and make corrections prior to creating the statement(s).

Click the Commit button to commit the Bill Print Run and create a production file of the Guarantor Statement(s).

Selecting to commit will create a production file and the services will be marked as billed.

If the Process button was chosen the system will process the Bill Print Run and create the Bill Print Status Report and a test file for the Guarantor Statement(s). When the system is done, the screen will refresh and at the bottom of the screen the Bill Print Status Report file will be listed as well as the test file of the Guarantor Statement(s).

To view the Bill Print Status Report click the View hyperlink. ShareCare will display the Bill Print Status Report.

For the Guarantor Statement users do not indicate any required fields in Bill Format Options as with other bill formats. On the Bill Print Status Report for the Guarantor Statement there will be no errors reported, only warnings. The warnings that will be reported will be missing addresses as well as those records in which the checkbox “Suppress Print of Guarantor Statement” is selected on the Guarantor / Billing screen.

Click the Close button when finished reviewing the report.

To view the test file of the Guarantor Statement(s) generated select the hyperlink under the Previously Generated Output area of the screen. The actual number or letter combination for the name of the hyperlink is generated by ShareCare and will change with each run.

A new window will open up in Actuate and the Guarantor Statement(s) just generated will display.

When finished viewing the test file of the Guarantor Statement(s) return to the ShareCare window users can either create a new test file from the same Bill Print Run or commit the test file to a production file.

To create a new version of the test file based on the same Bill Print Run, then return to the Batch Bill Print screen and select the Process button again. The system will process and create a new Bill Print Status Report and a new test file. Each version of the test file will be listed at the bottom of the Batch Bill Print Screen until the user deletes the Bill Print Run.

Users can continue to create new versions of a test file as many times as necessary. If different parameters and a new Bill Print Run for the generation of the Guarantor Statement is desired users must delete all Bill Print Runs first because records can only be part of one Guarantor Statement Bill Print Run. If you run a Guarantor Statement Bill Print Run and another user wants to run a Guarantor Statement Bill Print Run with overlapping guarantors, the system will prevent this from happening. Once a guarantor’s information is part of a Bill Print Run it is locked with that Bill Print Run until the run is deleted or committed as production file.

Select the Delete button at the top of the screen to delete the files.

When deleting the Bill Print Run, the system will display a confirmation message to verify that the run should be deleted. Click the OK button to delete the run, click the Cancel button to return to the screen

If the user leaves the Batch Bill Print screen, returns later, and still has an outstanding Guarantor Statement Bill Print Run that has not been deleted previously or committed into a production run, the system will display the following screen and message.

Select the Bill Print Run hyperlink to open up the Bill Print Run job statistics screen. To rerun the Guarantor Statement file using this Bill Print Run then select the Process button and create another version of the test file. To enter in new search parameters and create a new Bill Print Run for the Guarantor Statement(s) then select the Delete button to delete the Bill Print Run.

To create a production file, select the Commit button at the top of the Batch Bill Print screen.

The system will ask the user if they are sure they want to commit the run.

To commit the Bill Print Run to a production run click the Ok button. Click the Cancel button to return to the previous screen.

Users will have to reset any message settings and retype any print run messages that were made on the test file before committing the Bill Print Run to a production file. The system does not save these settings.

The system will create a new file from the test file that will be marked as a production file. All the services, payments, and adjustments that are included on the Guarantor Statements in a production file will be marked as billed in the system.

When the screen refreshes select the hyperlink for the name of the production file. A new Actuate window will open with the guarantor statement(s) that can now be printed and distributed to Guarantors.

Should I save a copy of the Guarantor Statement file?

It is strongly recommended that you save a copy of the Actuate file to your system’s hard drive. This is the best way to guarantee an exact copy of the guarantor statement for future reference.

To print the file select the Download/Print button at the top of the Actuate screen.

A new window will open in Actuate. Select the All radio button to save the entire file and then click the Apply button on the left hand side of the screen.

A File Download window will open, click the Save button

Select the folder/location to use to save the Guarantor Statement(s) and enter in a meaningful file name so you can locate the statements at a future date. The file will then be saved to the hard drive/disk as a PDF file. You can now print the Guarantor Statement(s) from the file saved on the hard drive/disk. Click the Save button to complete the process.

Close the remaining open Actuate windows to return to the ShareCare system to process additional Guarantor Statements.

Can I change the Guarantor Statement settings?

If this is the first time a production run of guarantor statement(s) for any entity, organization, and/or facility has been completed, users will no longer be able to change any of the “Bill Services on the Guarantor Statement at the x level” settings made on the Entity, Organization, or Facility screens.

Receivables

Receive Payments in ShareCare refers to line-item payment posting of a specific dollar amount to a single consumer service. Through the Receive Payments functionality users are able to select an invoice by consumer and apply payor, guarantor or alternate payments to individual service charges affiliated with that invoice. Through this feature, users can also make adjustments to consumers’ accounts to indicate write-offs for a variety of business reasons. Receive Payments is a manual process and all payments applied to service charges through this line-item method must be posted individually by the user.

Begin by selecting Receivables from the Fiscal section of the Main Menu.

Share Care will display the Receivables screen with the associated search criteria.

Users have the option of entering data to search by invoice number, consumer, guarantor, payor plan or insured ID. Enter the desired invoice number or search criteria. Click the Search button.

The system will return the desired invoice or a list of invoices based on the search criteria.

Select the desired invoice by clicking on its associated blue hyperlink. It will be displayed on the screen along with information associated with the invoice.

Transaction flags will appear, one for each service included in the invoice. To enter payment information, click on one of the Transaction flags.

Clicking on a transaction flag opens a screen that details specific information about the particular service related to the transaction. A summary view will display.

Click on the Detail button to review specific information about the transaction’s payment history.

Detailed information regarding the related service and payment history of the transaction displays including the Expected to Pay values for each payor plan. The Expected to Pay values listed are the amounts that are calculated during the billing process. They pertain to the usual and customary amounts available on the Charge Schedule or contracted rates that may be linked to the specific payor group(s) through Payor Contracts.

The Transaction screen shows previous entries, providing users with a history of the payments and credits applied to a transaction. Additionally, the Transaction screen lists payment dates, EOB approval dates, payment types, references and rejection codes. The Type field details either the actions that were taken to compute the charge (i.e. the system calculated the expected to pay amount from the charge schedule rates) or the entry a user added to record a payment or adjustment (i.e. a user entered an adjustment for a consumer’s deductible).

If an exclusion rule is recorded for a specific service and payor combination with drop through billing logic, the system will not bill the particular payor for the service but rather will drop the charge down to the next payor, if available. On the Receive Payments, the Expected to Pay balance for payors that are not charged for services based on the drop-through exclusion rules will display as $0.00. Within the Rejection Code/Exclusion Reason field, the application will represent the Reason Code associated with the given Exclusion Rule that was applied to the given service/payor combination. This information will be for references purposes only to detail those payors that were not charged for services due to exclusion rule functionality. If exclusion rules with stop billing logic are applied to a service/payor combination, the charges for the service will not be billed and therefore, will not be available through Receive Payments.

If users do not wish to review all of the transaction’s payment details the Summary button can be selected. If selected, only the total expected to pay and payment amounts will display.

Entering a Payment

Near the bottom of the Transaction screen, within the New Payment section, users can enter a new payment or adjustment

To add a payment, first specify a payor from the Payor drop down menu. The drop down menu will list all of the available payors for the selected service including the payor(s), guarantor and an alternate.

Next, choose a user-defined reference to make a note for the payment. A payment date must be entered as well as the payment amount in the corresponding fields. If a payment only partially meets an expected to pay amount due to a claim that is partially or fully rejected, users can choose to select a user-defined rejection code for their reference. An EOB approval date can also be added in the available field if applicable.

Once all information is entered, click on the Post Payment button to save the information and apply the payment.

If the amount entered equals the amount billed, the system adds the payment and applies it to the appropriate payor. The payment will display within the transaction payment information area of the screen.

If the payment amount entered is less than the amount charged, the system will display a screen inquiring where the rest of the payment should be applied.

The system notes the default payment source that should be billed under normal circumstances in gray. Users can accept the default or choose another appropriate payor source where the remaining balance should be transferred, such as to another payor, guarantor, or alternate source, by selecting the corresponding radio button and clicking Post Payment.

Users can choose to write off the remaining Expected to Pay balance as an adjustment by selecting the adjustment of their choice from the available menu and clicking on the Post Payment button.

The payment can also be canceled by selecting the Cancel Payment button.

Additional payments can then be entered for this transaction as outlined above.

If the payment amount entered is larger than the total charge, users will get a message indicating that a manual adjustment will need to be made to balance the transaction if the payment is applied to the selected source. Users can choose to continue or cancel the posting.

Entering an Adjustment

Users can enter adjustments for a consumer service directly through the Receive Payments screen. Adjustments can be made to remaining balances for a variety of reasons such as for charity care, ability to pay adjustments, bad debt, exclusion rules, etc. Once applied to a service for a particular payor source, the money that is adjusted is no longer owed by the specific payor(s) or guarantor but rather is noted in the system as a write-off. Through standard and ad-hoc reports users can track monies adjusted or written off and use the information for financial management purposes.

Select the payor source from the Payor drop down menu to which the adjustment should be applied.

The payor selected will have the final adjusted amount deducted from their Expected to Pay balance.

Click on the Adjustment checkbox. Select an option from the new Adjustment Description field.

Enter all other relevant data pertaining to the adjustment. When all data has been entered, click the Post Payment button.

As with entering payments, if the adjustment amount that was entered does not cover the complete balance due for the selected payor, users will be requested to indicate where the remaining Expected to Pay balance should be applied.

Likewise, if the amount entered exceeds the Expected to Pay balance for the given payor, a warning message will display, indicating that the amount entered is larger than the balance and if applied, may require an adjustment in the future.

Posting Cash Receipts

Cash receipts represent payments received from consumers or guarantors to cover service charges that are not otherwise covered by other carrier coverage. Cash receipts are taken in to pay for co-pay, coinsurance, deductible or other non-covered service expenses. Al cash receipts are initially recorded on the Cash Receipts screen.

Cash receipts that have been recorded for a particular consumer will be listed within the Cash Receipts section of the Receive Payments screen. Through this section, users are able to apply the payments received to the guarantor balances listed for specific invoices and transactions.

The Cash Receipts section details the date the payment was received, the user-defined type of payment, the location where the payment was received, and the amount of the payment. The section also details the amount of the payment, if any, that has been applied to other services as well as the remaining balance. Only the remaining balance can be applied to additional services.

Select the preferred cash receipt by clicking on the radio button next to the date field.

In the Amount field enter the amount of the payment that should be applied to the selected service as well as the Payment Date. Cash receipts can be applied to any number of services. Therefore, users can choose to apply the entire receipt to one service or portions of the receipt to many services.

Click the Post Cash Receipt button when all information has been entered.

If the amount that was applied does not meet the total balance due, a screen will display inquiring where the system should apply the guarantor’s remaining charges. Also, if the amount added exceeds the balance remaining, the system will display a warning indicating that the amount applied is above the amount due and that if the payment is applied, an adjustment may need to be made in the future.

Committed vs. Non-Committed Billing Runs

Users can perform billing runs and review the system data before committing a run to ensure that the billing cycle appropriately bills all services. Within the Receive Payments screen users will be able to preview the results of trial billing runs by examining expected to pay amounts for payors and consumers, however, payments will not be able to be posted for a trial billing run. Users cannot enter payments for invoices until the billing run they are viewing has been committed. The Receive Payments screen will warn users of invoices that were generated during trial runs that have not been committed yet.

Batch Receive Payments

Within Batch Receive Payments, a flat check amount covering a range of dates, services and invoices is posted within Share Care. The system then determines the specific dollar amount of the check that is posted to services within a single consumer account or across multiple consumer accounts, enabling users to quickly apply large payments to multiple consumers and services. Users have the ability to review and modify the services to which payments are applied before the payments are automatically posted in batch to the Receive Payments records. Once posted, the system creates a line-item payment record within Receive Payments to enable organizations to easily review all posted payments for individual consumers.

This functionality is useful for organizations that receive lump sum payments covering multiple services for one or more consumers. Payments can easily be applied to multiple services and/or multiple consumers at one time, without having to enter payments individually for each consumer service through the Receive Payments screen.

To access the Batch Receive Payments screen click the Batch Receive Payments tab.

The system will display a lookup screen where users can edit/view existing checks or create new checks.

Viewing/Editing existing Checks

Users can search for existing checks with in the system and update the data as needed by using the lookup provided. Enter the check number in the Check Number field or click on the Check Number hyperlink.

Click the Edit Check button when the system locates the desired check.

The check information will display.

Make the necessary changes and click the Update button at the top of the screen.

Creating New Checks

To add a new check to the system click on the New button at the top of the screen.

The system will display the fields associated with entering new checks.

Check the appropriate box to denote that the check was received from a Payor Plan or Payor Group. Enter the required Plan/Group, date the check was received, service begin/end dates and the check amount. Enter the non-required information as desired.

Click the Add button when finished.

The check number, the date it was received and the Payor Plan it applies to will display on the screen.

At this time, if you wish to apply the payment to specific consumers, select an option from the Search By option list. Either Consumer or Bill Print Run can be selected. Depending on which option you select, you will be able to perform a search by consumer ID, consumer name or Bill Print Run to find the consumer(s)/run to which you would like to apply the payment.

The following example will outline the process of selecting Consumer from the Option List. The screen will refresh with the available options for the user.

Once the search selection is made, enter the number of consumers you want to search for in the Enter number of Ids/lookups to generate field and click the Generate ID(s) button. For example, if the check reimburses for services rendered to two consumers and only the name of the consumers is known, click on the Consumer Lookup radio button and enter 2 in the Enter number of Ids/lookups to generate field.

The screen will display a list of boxes from which a search can be performed. Users can then search for the consumers they would like to apply the payment to by entering name or ID information in the boxes provided.

After selecting the consumers, click the Search button.

A screen will display listing services that were billed to the particular payor plan per the defined service dates for the consumer(s) selected.

Please note, when selecting consumers to apply payments to, the consumers selected must have reimbursable services on record that were billed to the specific payor plan during the specified date range. If the consumer does not have services on record that were billed to the payor plan during the appropriate time span, the system will provide a warning after the Search button is selected.

If no consumer records are selected when a check is added to the system, Share Care will automatically display all of the consumers and services that are applicable to the date range and payer plan to which the check pertains after the Search button is selected. As a result, consumers may be listed and have payments automatically applied to their outstanding service charges that are not covered by the specific payment.

Applying Payments

If users chose to apply batch payments from a payer plan check to a consumer(s), the system will display a list of the available services for the consumer(s) that are applicable to the payer plan and date range defined for the check. The services listed may span several invoices.

For each service listed, the system will automatically apply a portion of the payment to the listed services. To calculate the amount of money that should be applied to each service, the system starts with the oldest service first. It then looks at the Expected to Pay (ETP) amount for that plan for that specific service. If the amount of the check is equal to or greater than the ETP for the service, then the system will apply a portion of the check payment equal to the ETP for that service, thereby reimbursing for that service charge in whole.

After the first service payment is entered the system moves down to the next service and applies a payment amount equal to the Expected to Pay for that service. This continues until a payment is listed for all of the available services or until the check amount is fully distributed. The chronological order for the services is based on the date/time recorded when the service was rendered.

If a remaining payment amount is less than the ETP for a service, the system will automatically apply the remaining payment amount to that service. Users will have an opportunity to modify this amount before posting the payment to the consumer’s record if needed.

In the illustration above, the check amount was GREATER than the total charges for all services; therefore, all services had a payment amount applied to them.

In the illustration below, the check amount was LESS than the total charges for all services, as a result; only the first service had a payment amount applied to it. Once this payment is posted, all of the remaining services that did not have an amount applied will be available for future payment posting.

Before the payments listed for each individual service are posted, users may modify the payments that will be posted to each service. The amounts listed in the Payment Amount fields can be changed if needed. Also, the EOB Date or Payment Date fields for each service can be updated by entering new dates for each individual service or by universally updating the dates for all listed services by changing the EOB Date and Payment Date fields at the top of the screen and clicking on the Change button beneath the field(s).

Users also have the opportunity to indicate if payments should not be posted for a specific payment by clicking on the checkbox next to the given service to remove the checkmark. When the payments are posted, the payments for services that do not have checkmarks within their accompanying boxes will not be applied.

If users decide that none of the payments should be applied to the services, the Uncheck All button can be selected to indicate that none of the service payments should be applied. Of course users can re-select services for payment if they choose to do so.

At the bottom of the page there is a series of totals displayed. The first total corresponds to the total charges for all services or transactions. The second total represents the total of all Expected to Pay amounts for the listed services for the particular payer plan submitting the payment. The third total refers to the total amount of payments that are being applied to services. The Balance total refers to the remaining balance of the check that is being applied to payments. As payment amounts for services are adjusted, the balance will change to accurately represent the amount of the check that has not been applied to services.

After all modifications have been made to the screen, the Post button should be selected to apply the payments to the consumer’s records. After this button is selected a warning message will display, reminding users that only those payments selected with a checkmark will be submitted.

Click on the Ok button to continue. The system will post the payments to the Receive Payments screen, where users will be able to review the payments at a later time.

Immediately after the payments are posted, Share Care will display a screen that lists all of the payments that were posted. Note: This screen may only display briefly if no check balance remains.

If the amount posted was EQUAL to the Expected to Pay values for all services, a screen will briefly display noting the service charges that were reimbursed and users will be returned to the main Batch Receive Payments screens.

If the amount posted was GREATER than the Expected to Pay values for all services, the screen will note the remaining balance and will provide a location for users to create a refund check for the payer plan or will enable them to save the balance, which can be applied to additional consumers and services at a later time.

To create a refund payment, enter the amount of the refund, the refund date, and the refund check number, if known, and click on Refund. To save the remaining balance for future use, simply click on Cancel.

If the amount posted for a given service is LESS than the Expected to Pay value for that service’s Expected to Pay the system will automatically drop the remaining balance down to the next payer when the payment amount is posted. The remaining balance will first drop down to secondary or other subsequent payors if any exist. If no additional payer plans exist the remaining Expected to Pay balance will drop down to the guarantor. If the guarantor’s Ability to Pay is less than the remaining Expected to Pay, the guarantor will be assessed charges for monies up to their Ability to Pay. Any remaining balances will be automatically written off as an adjustment. Any of the amounts that are dropped down to additional plans, guarantors or adjustments can be manually modified on the Receive Payments screen. This process happens automatically within the backend of the system. Nothing will be displayed indicating that this is happening, but the Receive Payments screen can be accessed to confirm where the remaining balances were applied.

The drop through functionality will apply to $0.00 balances as well. If users change the payment amount of a service to $0.00 and the Post Payment checkbox is selected, the system will assume that $0.00 dollars should be applied to the service and the remaining Expected to Pay will drop down to the next payer plan, guarantor or adjustment. If the Post Payment checkbox is not selected, the system will not apply any payments to the service and will make that service available for future payment posting. Therefore, if you do not want to post any payment to an account, be sure that the Post Payment checkbox is not selected.

If users do not wish remaining Expected to Pay balances to automatically drop down to subsequent payer plans or guarantors, payments that are less than the Expected to Pay values should not be posted to services within Batch Receive Payments. In these instances, partial payments should be applied through the Receive Payments screen.

If payments are to be applied to more than one consumer, users will view a list of the consumers along with the service transactions that can be paid. Follow the above procedure for marking which services should be paid/unpaid. Remember to record the data for each consumer before clicking the Post button.