Search TipsSupplemental Billing
Supplemental Billing is an optional feature. Clients who want supplemental billing, generate a supplemental billing file daily from their patient accounting system. This supplemental billing file contains four types of accounts:
- In-house
- Discharged not final billed (DNFB)
- Outpatient not final billed
- Billed accounts without a primary contractual.
The purpose of this process is to have FinThrive calculate a Preliminary Expected Reimbursement (PER) for the products that are in production, thus giving the facility a closer estimate of its current AR.
The supplemental billing information is separate from the final-billed accounts in the regular Account Research function. Here is a list of the data elements contained in the supplemental billing file:
- Patient account number
- Patient name
- Admit date
- Discharge date
- Account type
- Patient type
- Hospital service
- Financial class
- Primary insurance
- DRG
- ICD-10 diagnosis
- ICD-10 procedure
- CPT4 (account-based)
- Bill date (interim or cycle)
Not all information is available for every patient. The PER amount is overlaid each time it is calculated by FinThrive. If FinThrive cannot calculate a PER amount (for example, if there is no payor code or DRG), then FinThrive sends a zero dollar PER amount. In the event that a previous PER amount was sent by FinThrive and now FinThrive needs to reverse/zero out the amount, a zero dollar PER amount is sent.
For accounts where FinThrive cannot calculate a PER amount, you can define a default percentage that can be applied as an overall percentage or applied by financial class. Where these defaults are defined, the default percentage is returned rather than a zero dollar PER.
In facilities that have supplemental billing, users can review the SB Account Worklist in the same way that they review the regular Account Worklist.