You can use the batch Status for payment batches to indicate the flow of the line item balance. For example, if the
Payer field is set to the primary payer, the charge settles to the secondary payer or to the patient if there is no secondary payer.
Note:
The patient responsibility date is the first date when responsibility for encounter payment falls completely in the patient bucket. In other words, you expect no payment from insurance, or insurance has already paid and the entire encounter balance is left for the patient.
In addition to settling the encounter to the next payer, you can also enter a status of Rebill, Appeal, or Deny
. The following table lists how each status affects the encounter status and its status in Balance Control.
Transaction Status | New Status of encounter after posting the transaction | Balance Control |
|---|
| Settled (if there is another payer) | R | Next Payer |
| Settled (if there is no other payer) | B | Patient |
| Rebill | R | Same Payer |
| Appeal | B | None |
| Deny | B | None |
| Forward to | B | Forwarded balances remain in a Billed status because while the balance moves to the next payer, the previous payer has forwarded the claim to the secondary or tertiary payer automatically - so a claim is not needed. |
Note: During transaction entry, when you enter a payment for a payer, the remaining balance does not automatically settle and move to an inactive or expired insurance. The remaining balance settles only to the next available payer, who is active. You can manually change the status that automatically generates.
