Overview

The Account Ledger feature is enabled by default. If you wish to disable this feature, please contact support by emailing ticket@icanotes.com to submit a request to disable the Account Ledger feature.

Before using this feature it is important to ensure your service codes, payer settings and billing rates are set up properly.

Service Codes

Practice owners and administrators have access to configure Service Codes. Service codes are set up in Settings under the Practice Settings tab. Click on the Service Codes Short List option to set up the service codes used in your practice.

Payer Settings

Practice owners and administrators have access to configure Payer Settings. Payer settings set up in Settings under the Practice Settings tab. Click on the Payer Settings option to set up your insurance payers.

Billing Rates

Clinician Billing Rates can be set up in your Personal Preferences under Revenue Cycle Management. 

Setting Up Client Insurance or Indicating Client Not Insured

The Account Ledger calculates client and insurance balances based on whether insurance is entered and if there is a copay. There will be a client balance with no insurance balance at all if the client does not have insurance. If the client has insurance with a copay, the client balance will be the copay amount with the insurance balance being the remaining difference between the charge amount and copay.

1. Click Add Insurance if your client has insurance and you'd like the client balance to reflect this.
   
2. If your client is not insured or they are self pay, toggle on the Self Pay option. 
   

Using the Account Ledger

Navigate to client's chart and click the Account button from the top bar. Click the arrow to expand the Account Ledger section seen in the image below.

At the top, you'll see both an Account Summary with totals and a With Applied Filters summary with totals.

 

You will also see columns displaying the Encounter Date, Service, Clinician, Note Status, Charge, Total Paid, Client Balance, Insurance Balance, Total Balance and an Invoice column indicating whether or not an invoice was created for the service.

 

Be default, charges associated with finished notes are displayed in the Account Ledger.

Filters can be applied or removed as needed using the option in each column. The default filter can be removed to see all charges on the account, including those associated with "In Progress" notes. In the example below, the client ledger is filtered to only show notes that are Finished. A visual indicator  shows you when a filter is applied to the ledger in a particular column. To remove the filter, click this button and select Filter.

From there, click Clear to remove the filter. Similarly, to apply a filter, you will use the same button but instead of using the Clear button, insert the criteria you wish to filter by and click Filter.

 

In the image below, I have chosen to clear the default Note Status filter to show all notes regardless of status.

In the menu available in each column, you'll also have the ability to sort the ledger details in ascending or descending order as well as customize which columns appear.

 

Adjusting Client Balances in the Account Ledger 

Billers can directly adjust client balances within the Account Ledger section using a new pencil icon in the Client Balance column. This feature ensures that when the client balance is updated, the insurance balance is automatically adjusted.

Clicking the pencil icon opens an editable field where you can adjust the client balance. 

 

After making changes, the system will prompt you to save them. Once saved, the insurance balance will be automatically updated to reflect the adjustment. 

If the entered client balance exceeds the total balance, the system will display an error message, preventing the change. 

Recording a Copay from the Client Appointment

A client's copay can be recorded within their calendar appointment.

Navigate to the calendar event and click on it to open the event. On the Session Details window, enter the Status "Occurred" and then click on the copay hyperlink to open the payment page.

Enter the Amount Collected and the Payment Type then Save.

You will be brought back to the Session Details window. Select "Start Note from Appointment" and select the Note Type. Use the Save button to save your session details and launch the note for the session. 

From the work area of your note, navigate to the final tab where you will be able to enter the Service Code. In the example below, I have created a Complete Evaluation and am on the Finish Initial tab. Use the Enter button to enter the appropriate Service Code(s).

From the Service Code window, select the appropriate code(s) from the Short List. The charge should populate based on what you set up in your Personal Preferences. When ready, click on Generate Invoice which will generate an entry in the client's account ledger.

You will be able to view the invoice on the confirmation window. Select View Invoice.

You will see the copay payment we collected reflected on the invoice.

From here, you may print or download the invoice, if needed. Otherwise, click Back to return to the note for completion. 

You will now see this entry in the client's account ledger.

 

Add Payment or Adjustment from Account Ledger  

To record a payment or adjustment, navigate to the client's chart and click the Account button from the top bar. Expand the Account Ledger section. Use the Actions menu to select Add Payment or Adjustment. 

In the example below, I am posting a $50 client payment to their $100 charge:

 

Fill out the Add Payment or Adjustment fields and click Save.

 

Transaction Type is restricted to client payment and client adjustment if the client does not have insurance. If the client has insurance, insurance payment and insurance adjustment options will also be present.

If you want the payment or adjustment applied to a single date of service, enter the same date of service in both the start and end date fields.

To apply the payment/adjustment to multiples dates of service, put the earliest date of service in the Start Date field and the latest date of service in the End Date field. This will allow you to apply a bulk payment or adjustment to multiples dates of service quickly. A payment/adjustment applied to a date range always applies to the oldest charge in the date range forward.

Upon saving, you'll see the account ledger update to reflect your payment/adjustment.

After posting the payment, my client now has a $50 balance on the $100 charge.

The steps to process a refund are found here: https://icanotesllc.zohodesk.com/portal/en/kb/articles/process-a-refund-from-the-client-chart

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Need additional assistance?

Phone: 443-203-5857 

Text: 866-301-0085

Email: ticket@icanotes.com

Chat: http://app.icanotes.com 

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Proprietary Notice Information: This article is provided for informational purposes only, and the information herein is subject to change without notice. While every effort has been made to ensure that the information contained within this article is accurate, ICANotes cannot and does not accept any type of liability for errors in, or omissions arising from the use of this information.