Benefits Verification workflow will begin the same as your standard PA creation workflow. The updated process will begin during the Verify process on the payment method. Within this training document whenever information is mandatory for verifying patient’s benefits those details will be called out in RED text.
- Create new Patient Agreement for patient
- Add Diagnosis Code (not mandatory)
- Add Product
Add all products – Covered & Non-Covered to PA prior to verifying benefits
If product is Covered, leave Time of Service line set to NO
If you will be placing Covered and Non-Covered products on the PA to verify the benefits for the Covered product(s), you can now place both covered and non-covered items on the PA PRIOR to verifying benefits in Patient Access, but it is VERY important that you change the Time of Service line to “YES” for the “Non-Covered” products
After saving each product the Self Pay/TOS indication will show as NO or YES on PA page
4. Import Primary Insurance OR Add Payment Method to PA
Importing Payor – if patient name, DOB and payor ID are populated proceed to Verifying benefits
Adding Payment Method – if manually adding the payment method these fields are mandatory
Select Payment Method
Enter Payor Name
Enter Policy #
5. Select Payor Name & Verify with VeriPro
6. Click View Coverage button
Selecting View Coverage button will allow you to view the patient’s benefit details:
You will automatically be redirected into the Patient Access visit:
7. Patient Access Visit Page
In the Patient Access Visit the patient’s benefits will either be auto-selected, or they need to be manually selected in order to receive the calculated Estimated Patient Responsibility
If the payor has auto-benefits set up, the Insurance Eligibility section will have blue checkmark and the deductible and coinsurance amounts will be populated. If these details are populated skip to section 10 of the training document
If the benefits have not been auto-selected the Insurance Eligibility section will have a red square and will not show deductible or coinsurance. If not set the benefits need to be manually selected.
Click on the Red button to select the benefits
8. Manually select Payor Benefits in pop-up box. For example: Remaining Deductible, Remaining Out of Pocket and DME Coinsurance (if applicable).
9. Review Selected Benefits details, Bill Charge & Contracted Rate
10. Read Patient Estimated Responsibility script
It is mandatory to read the scripting provided to each patient. This provides consistent message to all patients and clarity around this payment being an estimate of their responsibility.
11. Patient Agrees to Payment - Processing Estimated Patient Responsibility in MotionMD
After reading script and patient says they will pay, navigate back into Patient Agreement and click the PAY NOW button on the Commercial Payment Method line (no need to add Self Pay)
In the payment section the system will separate the Covered and Non-Covered products if both are on a patient agreement. The EPR from the patient access visit will be automaticlly imported into the pateint agreement. There will be a pill next to the charge to indicate INS for Insurance and TOS for Time of Service. Click the checkbox next to the Covered product and click the checkbox next to the Non-Covered item, complete the form and click Submit Payment button
12. Patient Declines the Payment
After reading script and patient says they decline to pay, navigate back into Patient Agreement and click the Decline Payment button on the Commercial Payment Method line.
13. Printing Patient Estimate document – as requested
PDF of Patient Estimate opens in new tab and can be printed:
14. Partial Payment – Processing a partial payment
A patient may elect to pay a partial payment amount vs. the total estimated patient responsibility. To process a partial payment, click the PAY NOW button on the Commercial Payment Method line as you would for a standard payment. There will be a pill next to the charge to indicate INS for Insurance. Click the checkbox next to the product options marked INS. This will open up the box with the dollar amount. Place your cursor in the box and manually edit the pricing to the amount the patient indicated they would pay. Complete the remaining steps for adding the credit card details and submit payment.
15. Check Payment – Processing a check payment
A patient may elect to pay their EPR using a check. To process a check payment, use the Revenue Advantage portal and follow the steps below:
- Open a new tab on your web browser and navigate to the Revenue Advantage web page: https://m.usapaymentexchange.com/?sUID=e7bdccba-decf-40fd-aa52-7dbccef93418&aid
- Follow the steps on the Check Processing article to collect the payment.
- Once the check payment has been processed via Revenue Advantage, attach the Payment Receipt to the PA.
- Include a Patient Visible note on the PA stating “XXX was collected towards patient EOB via Revenue Advantage on XX-XX-XXXX (date). See attached Payment Receipt.”
16. Multiple Credit Cards – Processing a payment on two separate credit card transactions
A patient may elect to pay their EPR using multiple credit cards. When processing the first credit card for a partial payment amount, follow the guidance provided under Section 14: Partial Payment – Processing a partial payment.
To process the second credit card for the remaining EPR amount, select Add under Payment Method and select Self Pay.
Select Pay Now to process second payment:
Click the checkbox next to the product options marked TOS. This will open up the box with the dollar amount. Place your cursor in the box and manually edit the pricing to the remainder amount of EPR owed. Complete the remaining steps for adding the credit card details and submit payment.
Include a Patient Visible note on the PA stating “XXX was collected towards patient remaining EPR under Self Pay as patient made 2 partial payments towards EPR on separate credit cards”
NOTE: On the Patient Agreement add a patient visible note stating a partial payment was processed
**PRINTABLE PDF AVAILABLE**