I suggest you ...

Assess fees without making an "appointment."

We charge patients for past due payments, returned checks, filling out forms, and refills outside of appointments. At the moment, in order to create those fees, we have to make an appointment. But that makes their "last appointment" inaccurate.

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    Sarah shared this idea  ·   ·  Flag idea as inappropriate…  ·  Admin →

    13 comments

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      • Cindy commented  ·   ·  Flag as inappropriate

        Max, your idea would certainly work for posting of fees such as returned check fees, form fees, and past due payment fees. For refills outside an appointment, the refill has to be approved by a provider and that order should be documented in the patient chart and the refill documented in the Medications List in the patient's chart. Communication Log may not be the best option for Prescription refills.

      • Max commented  ·   ·  Flag as inappropriate

        Just had an idea, how about using the Cash Charge in the Communication Log? Those aren't associated with an appointment.

        Patient Chart on Web EHR->Communication (left side)->Communication Logs tab

      • Cindy commented  ·   ·  Flag as inappropriate

        Until drchrono resolves this issue, perhaps these suggestions that we use will help:
        - Create an Exam Room on your schedule that will be used for things charged for outside an appointment. We have an exam room for "Product Orders" because our patients order supplements outside an appointment. Use that schedule to create appointments for things outside an appointment which need to be charged to the patient.
        - For things like returned check fees that may be acceptible to add to an appointment, create a custom code for those charges or credits and add them to the related appointment. For instance, if a check is returned for a payment made for a visit on 1.1.18, add the charge to the billing for that appointment as that charge relates to the appointment.

        For sure, drchrono is NOT meant to be used by Cash Practices. We are finding it extremely difficult to incorporate billing for our cash practice.

      • Grace Bellinger commented  ·   ·  Flag as inappropriate

        It should be like patient payments page. You can post a payment that isnt associated with a visit--it seems like it would be viable to create a way to post charges to this page too.

      • Brieanna Jennings commented  ·   ·  Flag as inappropriate

        We sell products & use custom codes to track inventory, so this is a huge problem for us, too!
        What we did is create a seperate office called "Products and Purchases" where we'll schedule the appointment. It's worked out well for us so far.

      • Michael commented  ·   ·  Flag as inappropriate

        Huge headache! Trying to figure out how to bill for a phone call. Communication Log only allows charging pt cash and not creating a claim for 99441...

      • Max commented  ·   ·  Flag as inappropriate

        @Anonymous
        If you make an appointment profile (scheduling->appointment profiles) for these "fake" appointments, you can have it automatically set the reason. The workflow becomes: every time you make a fake appointment, just select the fake appointment profile and enter the charges in the billing tab. This is useful because when sending referrals it shows you the appointment reason. You could set the reason to "billing only appointment do not include".

        You can take this a step further by creating a fake exam room specifically for fake appointments. You would need to make an appointment template (scheduling->appointment templates) that covers the exam room for each day of the week. Then when you click in that exam room, it automatically sets the appointment profile to your fake appointment profile. The workflow after setup is just clicking on the schedule, picking a patient, and entering charges.

        If the fake exam room is cluttering your schedule view, make a fake office.

      • Anonymous commented  ·   ·  Flag as inappropriate

        @Max- You're exactly right! It also means that I have an empty note that I have to remember is not real, when sending records to others.

      • Max commented  ·   ·  Flag as inappropriate

        @Rita E. Greene
        The only problem with a Records Requests and Refills appointment is that it changes the "Last Appt" (shown when you open the patient chart, or when hovering over the patient on the schedule).

      • Rita E. Greene commented  ·   ·  Flag as inappropriate

        Just a suggestion...We created custom codes attached to some of our billing. You could so that for past due payments and returned checks and add the custom code to the date of service it corresponds with. For Medical Records and refills outside of appointments I would also create the custom codes and create appointments for Records Requests and Refills and enter the appointment with the custom code billing.

      • Max commented  ·   ·  Flag as inappropriate

        This is a side effect of drchrono's appointment-based design. With the current system, every claim and every payment (by payment I mean all billing information) is associated with an "appointment", which is sort of drchrono's version of an "episode of care".

        To implement your suggestion would require a re-working of the core design, since you suggest disassociating "appointments" with payments. This is like asking a library to switch from alphabetic sorting by genre to flat alphabetic sorting, aside from reorganizing the library people would have to adjust how they look for books.

        Your current workaround (making appointments) has the problem of changing the patient's "last appointment". I noticed that you can edit the "last appointment" at the bottom of the patient's demographics under the important tab. Unfortunately it isn't practical to edit the "last appointment" field every time you make a transaction.

        Because you can change what shows as the "last appointment", drchrono must store it separately (as opposed to looking up the last appointment every time you open a patient's chart).

        Here is an alternate suggestion: drchrono could add a check box to each appointment whether to update the patient's "last appointment". Then you could make an appointment template for your fees which automatically turns off that check box.

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