Ledger Card section

OMSVision Ledger uses a line item accounting method. The Ledger Card section contains a line item for each posted procedure. The procedures are listed chronologically and grouped by the posted date (the first column).

The Ledger Card section has the following sections:

· Main section

· Current section

· Original section

· Claim Status section

· Last section

· Totals

Main section

The following is an explanation of the columns in the main section (when the Ledger Card is scrolled all the way to the left):

· Posted - The date the procedure was posted.

· Complete - The date the procedure was completed.

· Code - The procedure code, as found in the fee schedule, that was posted. The color of the code field indicates the status of the code:

· Red - The patient is responsible for the balance for the procedure code.

· Green - The insurance is responsible for the balance for the procedure code.

· Gray - The patient and insurance are each responsible for a part of the balance for the procedure code.

· Blue - The procedure code has been paid in full.

· Yellow - The line was added as a correction for a procedure code that was edited or deleted (if the preference setting to allow the creation of reversing entries for edits or deletions is enabled).

· Pink - The insurance denied the claim for this procedure code.

· Brick Red - The balance for this procedure code has been converted.

In addition to the color legend, the first digit or letter indicates the following:

· 0 - A new procedure

· 1, 2, 4, or 5 - A primary, secondary, tertiary, or quaternary insurance payment

· 3 - A patient payment

· 9 - An adjustment

· A, B, C, and so on - For multi-visit procedures, the second, third, fourth, and so on visit

· Insurance - The code that appears on the insurance claim form. This is set up in the fee schedule.

· CPT - The associated CPT (medical) code.

· Dx - The associated medical diagnosis code (if there are more than one, only the first one appears). According to a certain preference setting, either the ICD-9 or ICD-10 code appears.

· Loc - The location where the transaction was posted. This column appears only if multiple locations have been set up.

· Dr. # - The doctor associated with the procedure.

· Service - The description of the procedure.

· Tth - The tooth number associated with the procedure.

· Billed - The total amount billed for the procedure.

· UCR - The usual and customary fee charged. The availability of this is determined by a preference setting.

· Paid - The amount paid for the procedure.

· Adjust - The amount of any adjustment for the procedure.

· Balance - The balance for the procedure.

· Summary Line - When multiple procedures are posted on the same date, a summary line appears below the group of procedures with the same posted date. That day's totals for the billed, UCR, paid, adjusted, and balance columns are displayed on the summary line. Ledger notes associated with the procedure or payment, or that were added separately.

· Notes - Ledger notes regarding the procedure.

· Payment By - The method used to make a payment for the procedure.

· Check # - The check number if the method of payment was by check.

· Bank # - The bank number if the method of payment was by check.

Current section

The following is an explanation of the columns in the Current section of the Ledger Card section:

· Proc. Bal. - The current balance for the procedure, including patient and insurance portions.

· Pt. Bal. - The current portion of the procedure balance for which the patient is responsible.

· Ins. 1 - 4 Bal. - The current portions of the procedure balance, split by primary, secondary, tertiary, and quaternary insurance that the insurance companies are responsible for.

Original section

The following is an explanation of the columns in the Original section of the Ledger Card section:

· Ins. 1 - 4 Est. - The original estimated portions of the procedure balance, split by primary, secondary, tertiary, and quaternary insurance that the insurance companies are responsible for.

Claim Status section

The following is an explanation of the columns in the Claim Status section of the Ledger Card section:

· Ins. 1 - 4 Claim - The status of the claim form for the procedure, split by primary, secondary, tertiary, and quaternary insurance. The status can be one of the following:

· Not Submitted - The claim form, for the procedure, has not been generated or submitted.

· Hold - The claim form, for the procedure, has been submitted to the primary insurance carrier, the patient has additional insurance coverage, but the claim has not been submitted.

· Queued - The claim form, for the procedure, has been sent to the batch, but has not been printed or sent electronically.

· Sent - The claim form, for the procedure, has been printed or sent electronically.

Last section

The following is an explanation of the columns in the last section (when the Ledger Card is scrolled all the way to the right):

· Pre Auth # - The pre-authorization number entered in the treatment plan when the estimate was returned or entered during posting.

· Trans Date - The date the transaction was created.

· Trans Time - The time the transaction was created.

· Workstation - The user that posted the transaction (security accounts must be set up to see the users).

· Claim No. - The claim number for the transaction.

· Claim No 1 - 3 - The claim numbers, split by primary, secondary, tertiary, and quaternary, for the transaction.

· Submit To - Whether or not the procedure is being submitted to insurance, and if so, the type of insurance.

· CPT Description - The descriptions of the CPT (medical) codes that are attached to the procedure.

Totals

There are totals at the bottom of the Ledger Card section:

· Totals for the Billed, UCR, Paid, Adjust, and Balance columns are displayed.

· Statistics about the patient's appointments are displayed - the number of cancelled, failed, and kept appointments; and a percentage of kept appointments.