The Other menu contains adjustments, refunds, comments, and claim statuses.
Comments allow you to enter short notes on a patient's ledger. They are often useful for clarifying unusual ledger activity, such as transfers between accounts. To create a comment, New Comment from the Other menu. You can enter a Short Description (required), which will appear as a line item in the ledger. You can also add additional details in the Comment field, but this will not be displayed on the ledger; you must double-click the comment to view this information. When you are finished entering the comment, click OK to save.
Comments can also be printed on statements, if you wish. The comment will not appear on the statement unless Show On Statement is checked. If you leave the Show On Statement box unchecked, you only will be able to view the comment in the ledger.
By default, only the comment's short description will appear on a statement. If you wish to have the long description printed as well, go to the MacPractice menu, select Preferences, then select Statements in the preference sidebar. Under the Statement Options tab is a checkbox labeled "Print Comment's 'Long Description' on statements". Check this to include the long description as well.
Your changes will be saved automatically when you close the preference window. This is a local preference, so it must be set on each computer in your office individually.
Positive Adjustment is used to add to the patient's balance. Positive adjustments must be associated to a procedure. To create a positive adjustment, select a procedure on the ledger, then go to the Other menu and choose Positive Adjustment (or use the Option-Command-Equals keyboard shortcut).
Enter the amount of the adjustment in the Positive Adjustment By Amount field, and enter an Adjustment Type if necessary. The Adjustment Type is a brief description of the reason for the adjustment, such as "NSF Fee". You can enter additional information in the Description of Adjustment field, if you wish.
When you have finished entering your information, click Save to close the adjustment window.
The Negative Adjustment is used to subtract a dollar amount from the patient's account. To create a negative adjustment, go to the Other menu and choose New Negative Adjustment. Negative Adjustments can be applied to any patient in the account and to any procedure. They are exactly like patient payments, except they do not appear on your deposit slip.
When the adjustment window opens, enter an amount in the By Amount field, and an Adjustment Type, if necessary. Apply the payment as you would if it were a patient payment, and click Save to close the window.
You can refund a payment if it has an unapplied amount. You can refund the unapplied amounts of a patient or an insurance payment.
If it does not have an unapplied amount, you will need to open the payment and edit the information in the Payment column, until the Remaining amount of the payment equals the amount you wish to refund. To create a refund, go to the Other menu and choose Refund. The Refund window will open.
Patient Payment Refund
A patient payment refund is quite simple. First, you'll need to select the payment you wish to refund. This payment must have an unapplied portion still on it or you won't be able to refund the payment. Then choose "Refund" from the Other Menu.
In the Refund window, enter a Refund Reference # if you wish (this could be the check number used to issue the refund, for example) and the Refund Amount. You may also enter a Date to associate to the item. This is the equivalent to the Procedure Date.
If the refund was issued by applying a credit to the patient's credit card, check the By Credit Card checkbox. This checkbox will be checked by default if the original payment was a card payment. On your Deposit Slip, the payment line item will list both the Total Payment Amount, and the Payment Excluding CC (credit card) Refunds.
Insurance Payment Refund
When you select Refund with an insurance payment selected, you will have some additional options in the Refund window.
As with a patient payment, you will need to enter a Refund Reference #, Refund Amount and Date. In addition to these fields, you have two checkboxes: "Refund credit to provider" and "Refund credit to patient". The "Refund to patient" option is used with insurance overpayments. Click here for more information.
The "Refund to provider" option is generally used with withholdings (WO) or forwarded balances (FB) from an ERA (Electronic Remittance Advice). If you encounter these terms on an ERA, please call the MacPractice EDI Department for assistance.
If you are simply refunding the payment back to the insurance company, leave these boxes unchecked.
When you are finished entering the refund information, click OK to save.
Reverse Payments are used to show a payment that has bounced or was rejected at your bank. It is also used for reversing credit card payments if your office uses AuthPayX credit card processing.
This usually is a patient payment. To use Reverse Payment, select the payment on the ledger and go to the Other menu and click on Reverse Payment. This creates a Reverse Payment line item on the ledger. The amount that was reversed will be added back to the patient portion of the ledger. ***Reverse Payment*** will show under the Description column of the payment that was reversed.
The Return Item option is utilized when a given Procedure Code has Inventory Items that have an Association of "Sold". The Return Item option will return said item to the Inventory, adjusting the quantity of the Item accordingly.
Paper claims will generally only use two statuses. When you first create a paper claim, it will be set to Outstanding. This is a status that is only used by the software; you cannot set claims to this status manually. If you have a paper claim you wish to manually change from Paid/Closed to Outstanding, MacPractice recommends using Sent or Accepted. For purposes of patient/insurance portion allocation, they are the same. Once the claim is paid, it will be set to Paid/Closed.
There are six status options in the Other menu, that can assist with managing your claims.
- Set Claim Status Sent: Once an eClaim has been submitted, it will be set to this status.
- Set Claim Status Accepted: Once an eClaims has been acknowledged by the payer, it will be set to this status.
- Set Claim Status Rejected: If an eClaim is rejected by the payer or clearinghouse, it will be set to this status.
- Set Claim Status Paid/Closed: Once an eClaim or paper claim has been fully paid, it will be set to this status. This is the only status that counts as "closed". All other statuses count as "outstanding".
- Set Claim Status Invalid: If an eClaim is missing vital information that must be present before it can be submitted, it will be set to this status.
- Set Claim Status Ready: If an eClaim is ready for submission, it will be set to this status.
If you have an amount that is in the wrong portion, you may find our portion troubleshooting guides helpful:
- With Insurance Estimating
- Without Insurance Estimating
Resubmit Insurance Claim
Selecting Resubmit Insurance Claim will reprint a second copy of a paper claim, with the same Sig on File date as the original claim. A new line item will be added to the ledger, indicating the claim was resubmitted.
- Unapply Selected Charge: If you have a charge selected, select this menu item to unapply all payments applied to the charge. If a payment was applied across multiple charges, only the portion applied to the selected charge will be unapplied. If there are write-offs associated with the charge, they will be deleted.
- Unapply Selected Payment: This will unapply the payment from any charges it is associated to, and move the entire amount of the payment to the Unapplied portion. If it is an insurance payment with write-offs associated to it, the write-offs will be deleted.
- Unapply Negative Adjustment: This will unapply the selected adjustment from all charges it is associated to, and move the entire amount of the adjustment to the Unapplied portion.
For more information about unapplied payments, click here.
When you select this option, a save window will open, allowing you to choose a name and location where you would like to save the file. Click Save to finish the export. A .xls file will be saved in the desired location. You can import this file into the spreadsheet program of your choice.