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Ledger - Balance Information

The table at the bottom of the Ledger Ability contains a breakdown of Account financial information.

Account Balance
This is the total sum owed by every Patient in the Account. If multiple Patients exist in the Account, this number will most likely not match the Patient's balance.

Ins. Portion
This number is the total amount estimated to be owed to the Account from Insurance.

This is based on a couple of different factors.

  • The way plans and charges are setup with Insurance Estimating. If Insurance is estimated to cover a specific amount, that amount will be reflected in the Ins. Portion.
  • Any unpaid open claims without Insurance Estimating will show the total amount unpaid in the Insurance Portion. Upon payment, the remainder of the amount owed will transfer to the Patient Portion.
  • Information on how the Portions will break down can be found in the  Portion Troubleshooting table.

If multiple Patients exist in the Account, this number will most likely not match one Patient's balance.

If Insurance Estimating is used, this number will decrease even if a payment hasn't been applied. This helps estimate how much Insurance is expected to pay so that the Patient will have a more accurate expectation of what they owe.

Patient Portion
This number is the total amount estimated to be owed to the Account from the Patient or Patients on the Account.

If multiple Patients exist in the Account, this number will most likely not match one Patient's balance.

If Insurance Estimating is used, this number will reflect what the Patient is most likely to pay based on the details entered into MacPractice.

Unapplied
This is the amount of payments that have been posted to the Account but not yet applied to any charges. This number will appear in red if it is any amount except $0.00. Unapplied payments will appear in the Transactions Table for every Patient in the Account, but may be intended for a charge on a specific Patient's Ledger.

Primary Coverage
This number reflects the cost that insurance is expected to cover in a year. This number is set in the Insurance tab of the Patient Ability. Insurance payments will cause this number to decrease (so if Insurance pays $100, then $100 will be removed from the Primary Coverage). The number will also decrease if Insurance Estimating is used. This serves to keep an estimate of how much an insurance company is likely to pay on the patient's behalf.

This does not take into effect any service the insurance may cover outside of the office if it is not kept track of in the office's Ledger.

If no Insurance Plan is set for the Patient, then "No Insurance Plan" will appear. Once a Plan has been applied, the Primary Coverage will appear in blue text.

If multiple Insurance Companies are used by the patient, this number will only reflect the Primary Coverage from the Primary Insurance (or the Insurance Company listed on the top of the Patient's Insurance tab.)

This will only apply to the selected Patient. If there are multiple Patients on the Account, another Patient will need to be selected in order to see their Primary Coverage.

Deductible
This is the Deductible that the patient will pay based on their Insurance carrier. Similar to Primary Coverage, this number is set in the Insurance tab of the Patient Ability. A Deductible is applied if the Charge has a Procedure Type that is designated Applies to Deductible in the Plans tab inside the Insurance Company Reference.

If no Insurance Plan is set for the Patient, then "No Insurance Plan" will appear. Once a Plan has been applied, the Deductible will appear in blue text.

If multiple Insurance Companies are used by the patient, this number will only reflect the Deductible from the Primary Insurance (or the Insurance Company listed on the top of the Patient's Insurance tab.)

This will only apply to the selected Patient. If there are multiple Patients on the Account, another Patient will need to be selected in order to see their Deductible.

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