Aging Calculations

[atd]

I'm confused about how the aging is calculated for a patient. Here's an example:
A patient had no insurance and the balance ended up going over 90 days aging. Then we found out the patient had insurance retroactive for all but the first date of service. The claims were sent and paid for by insurance, but the first DOS is still owed by the patient. Another statement printed today, but the amount due is now in the 0-30 day column instead of the over 90 - even though the charges owed are from 12/23/08.

I've also noticed that if insurance does not cover a service we expected it to and a statement is generated after the claim is paid by insurance that it comes up with the dunning messages for aging balances - even though it's the first time the patient has been billed.

Can someone explain the calculations happening behind the scenes for the aging balances? Is the first example some kind of bug?

[jordansparks]

There is a set of 30-day buckets. All procedures are dropped into their respective buckets. Payments are then applied to the amounts in the buckets, starting with the oldest balances. So the payments aren't actually tied to their respective procedures when calculating aging. It would, in theory, be possible for us to enhance the calculation when applying insurance payments. But we are sort of waiting until we have enhanced the main program to allow patient payments to be more easily applied to individual procedures.

Aging starts from the date the procedure is done without a grace period for insurance to pay.

[atd]

Since insurance payments are linked to the claims and procedures I assumed it would reduce the aging from the correct bucket based on date of service. Of course patient payments that are not linked to procedures would apply to the oldest patient balance. Would this change be easy to implement before the main program is enhanced? As a non-profit we are audited annually and our aging receivables is scrutinized closely.

For the other issue with the first bill to the patient showing past due messages, I can understand why the amount goes into the aging category that it does. I just wish there was a way to know if the patient had been sent a statement for those services before or not, and exclude the message if it was the first time we were asking for the money. If not, then having an indicator on the Bills window for the statements that have past due messages would be helpful - that way we could verify that it is indeed past due before printing that message out.

[jordansparks]

No, I would not say it's an easy change. An overhaul would be likely to introduce bugs. It makes the most sense to attempt that overhaul after patient payments get regularly attached to procedures. Do it all at once.