Third Party A/R Posting Definitions

Third Party A/R Postings are used to satisfy the charges a client received for services at the clinic.

In the Third Party A/R screen, double click on the empty box next to a Service in the grid at the top right.

The service details will highlight in the grid and automatically populate fields at the bottom left of the screen.
Other fields may not automatically populate. When applicable, you will need to enter amounts into one or more fields to properly apply all charges.

The fields are:

• Payer – The payer is the private company or government agency that provides medical coverage to the client.
• Charge Amount – This is the amount that the clinic charges for a particular service.
• Contractual Adj – At times the Third Party Payer has a contractual agreement to pay less for the service than the amount the clinic charges. The clinic still bills the full price, but adjusts the amount after the payment is received. This difference between the amount billed and the amount allowed is entered into the Contractual Adj field, and a reason selected from the drop down menu on the right.
• Gen Adj – Adjustments to a client’s charge may be made for reasons other than contractual agreements. The amount being adjusted would be entered here, and a reason selected from the drop down menu on the right.
• Copay – Many third Party Payer agreements call for a patient to pay a set amount at each visit. This amount is entered into the Copay field.
• Coinsurance – Many Third Party Payers only cover a percentage of services. For example, the Third Party Payer may only cover 80% of charges, and the other 20% is client responsibility. The amount of patient responsibility is entered in the Coinsurance field in dollars and cents.
• Paid by Payer The amount the Third Party Payer is including for this service in the check being processed is entered into the Paid by Payer field.
• Deductible – Many Third Party Payers only cover charges after a set annual amount is first paid by the client. This amount, often thousands of dollars, is referred to as a Deductible. When the clinic requests payment for a charge, the Payer does not pay it, but applies that amount to the client’s Deductible. The client is responsible for all charges until his or her deductible is met.
• Charge to Client – This field directs SAMMS to add a charge to the Payment tab in a client file. The amount is the client’s responsibility.

*When the Claim Batch is posted, this charge will be shown in the Payment tab of the client file.

• Batch Balance – This is the total amount in dollars and cents that needs to be entered into one or more fields for the charge to be satisfied.

Buttons at the bottom of these fields help you to navigate the grid at the top right of the Third Party A/R screen.

• Save and Next Line saves any changes you may have made and updates the grid. The next service detail is automatically highlighted.
• Cancel Line removes the highlighted service detail from the grid.
• Previous LIne highlights the service detail above the last one you were working on.
• Next Line higlights the service detail immediately below the last one you were working on.