Patient Accounts: Proof Calculation and A/R History Maintenance

Version 14.19

About Patient Accounts: Proof Calculation and A/R History Maintenance

Path: Billing tab > Proof Patient Accounts button

The Patient Account Proof Calculation and A/R History Maintenance window houses several important functions. Within this window, you can display three cross-referencing database proof calculations, review any accounts out of proof, if they exist, and process A/R Data Update Procedures.

In addition, there are two processes you will need to run before you begin to utilize the new set of financial reports contained in OP versions 11.4.16 and higher. The first is to run a maintenance procedure on the Proof Calculation Tab and a Set-up process on the A/R Data Update Procedures. Directions on how to run these processes are included in the sections that describe the tab.

Proof Calculation Tab

The Proof Calculation tab provides three proofs when balances are calculated. The proofs are as follows:

  • Proof 1 indicates the sum of balances shown in the patient registry. Each time a charge, payment, or adjustment is posted, a running balance is updated in the patient directory. The numbers shown here calculate the sum of all patient and insurance balances from the patient directory.
  • Proof 2 shows the sum of balances on each transaction. The insurance (TX_BALANCE) and patient (COPAYBALANCE) columns within each transaction are automatically calculated each time a charge, payment, or adjustment transaction is added to a patient's claim. A query then sums up these columns and presents the results here. It includes daysheet transactions, non-daysheet transactions, and voids. 
  • Proof 3 shows the calculation of balances on all transactions. The insurance (TX_BALANCE) and patient (COPAYBALANCE) columns within each transaction are automatically calculated each time a charge, payment, or adjustment transaction is added to a patient's claim. The results shown here, calculates the total Insurance and Patient balances by using the same equation that is used in the calculation of each of the transactions balances explained above. It includes daysheet transactions, non-daysheet transactions, and voids.
    The first time you come to this tab you should begin by clicking the Run button. Office Practicum’s maintenance procedure will recalculate all balances in the patient register and will attempt to correct any out-of-proof accounts. In addition to auto-correcting certain types of out-of-proof claims, the function checks for out-of-range service dates and assigns the Provider ID of zero to any instances where the Provider ID was not originally included.

Accounts Out of Proof Tab

The Accounts out of Proof tab recalculates accounts shown in the grid or recalculates all accounts based upon the button selection. Two buttons are available on the Accounts Out of Proof tab: Refresh and Update.

  • Clicking the Refresh button recalculate the accounts showing in the grid.  
  • Clicking the Update button will recalculate all accounts. It may take some time to recalculate all accounts so it is only recommended to recalculate all accounts during off-business hours.

A/R Data Update Procedures Tab

The A/R Data Update Procedures tab is used to set up or update the A/R History Analysis form.  

  • Clicking the Set up button will set up the A/R History Analysis window. This only needs to be performed manually once (your first time). Afterwards, the values are updated after a daysheet is run.  
  • The Update button should be clicked after the last daysheet for the day has been processed. Clicking the Update button should be used on a consistent basis to ensure you are updating your most recent daysheet data on your A/R reports.

Version 14.10

About Patient Accounts: Proof Calculation and A/R History Maintenance

Path: Reports Menu > Proof Patient Accounts (Keyboard Shortcut keys: [Alt][R][P])

The Patient Account Proof Calculation and A/R History Maintenance window houses several important functions. Within this window, you can display three cross-referencing database proof calculations, review any accounts out of proof, if they exist, and process A/R Data Update Procedures.

In addition, there are two processes you will need to run before you begin to utilize the new set of financial reports contained in OP versions 11.4.16 and higher. The first is to run a maintenance procedure on the Proof Calculation Tab and a Set-up process on the A/R Data Update Procedures. Directions on how to run these processes are included in the sections that describe the tab.

Proof Calculation Tab

The Proof Calculation tab provides three proofs when balances are calculated. The proofs are as follows:

  • Proof 1 indicates the sum of balances shown in the patient registry. Each time a charge, payment, or adjustment is posted, a running balance is updated in the patient directory. The numbers shown here calculate the sum of all patient and insurance balances from the patient directory.
  • Proof 2 shows the sum of balances on each transaction. The insurance (TX_BALANCE) and patient (COPAYBALANCE) columns within each transaction are automatically calculated each time a charge, payment, or adjustment transaction is added to a patient's claim. A query then sums up these columns and presents the results here. It includes daysheet transactions, non-daysheet transactions, and voids. 
  • Proof 3 shows the calculation of balances on all transactions. The insurance (TX_BALANCE) and patient (COPAYBALANCE) columns within each transaction are automatically calculated each time a charge, payment, or adjustment transaction is added to a patient's claim. The results shown here, calculates the total Insurance and Patient balances by using the same equation that is used in the calculation of each of the transactions balances explained above. It includes daysheet transactions, non-daysheet transactions, and voids.
    The first time you come to this tab you should begin by clicking the Run button. Office Practicum’s maintenance procedure will recalculate all balances in the patient register and will attempt to correct any out-of-proof accounts. In addition to auto-correcting certain types of out-of-proof claims, the function checks for out-of-range service dates and assigns the Provider ID of zero to any instances where the Provider ID was not originally included.

Accounts Out of Proof Tab

The Accounts out of Proof tab recalculates accounts shown in the grid or recalculates all accounts based upon the button selection. Two buttons are available on the Accounts Out of Proof tab: Refresh and Update.

  • Clicking the Refresh button recalculate the accounts showing in the grid.  
  • Clicking the Update button will recalculate all accounts. It may take some time to recalculate all accounts so it is only recommended to recalculate all accounts during off-business hours.

A/R Data Update Procedures Tab

The A/R Data Update Procedures tab is used to set up or update the A/R History Analysis form.  

  • Clicking the Set up button will set up the A/R History Analysis window. This only needs to be performed manually once (your first time). Afterwards, the values are updated after a daysheet is run.  
  • The Update button should be clicked after the last daysheet for the day has been processed. Clicking the Update button should be used on a consistent basis to ensure you are updating your most recent daysheet data on your A/R reports.