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Credits and Owings - Investigating

Sometimes, patient or insurer accounts will show a credit or owing balance and you might not be sure why they have this balance on their account.

Here are a few tips and examples you can reference when investigating these amounts in your account:

Outstanding Balances

An outstanding balance indicates that there is an invoice that has not yet been paid in full.

When viewing a patient profile, the Private Outstanding balance represents the total value of invoices that this patient has yet to pay.

Also of interest may be the Claims Outstanding value, which represents the total unpaid invoices billed to an insurer associated with this patient account.

The Private Balance amount is the difference between the Private Outstanding amount and the amount of Credit available on the account.

If an outstanding balance is owing for a client, the amount will show in red in the right-hand “Balance column” from the Profile > Billing > Purchases area.

If you are interested in pulling up only outstanding line items, you can do so by clicking on the Filter button and setting the status to All Outstanding.

You’ll see in the example below, that both private and insurer outstanding balances are brought up, corresponding to the $262.50 and $21.00 respectively.

Outstanding Balances will appear on the Accounts Receivable Report for the duration the invoice is unpaid.

 

Outstanding Credit

Account credit suggests that there is either (1) a payment that has not been applied in full, or (2) an outstanding credit memo on the account.

The total combined value of regular payment credit and credit memos will also display in the dashboard at the top of a patient’s account.

If the credit is a result of an unapplied payment, you can review any payments with a balance remaining by visiting the Patient’s Profile > Billing > Payments area.

Similar to what we did with invoices, you’ll be able to review the relevant payments by using the Balance Remaining filter.

If the credit is a result of a credit memo, you can review existing memos by visiting the Profile > Billing > Credit Memos area of the account. You can click on the word View to the right to investigate any notes that may have been left:

For credit memos created in error, you can delete it by clicking on the red Delete button on the left:

Outstanding Credit will appear on the Credit Report for the duration the payment or credit memo remains unapplied.

 

Example Scenarios

So, now that we know the relevant line items where an outstanding balance or credit comes from, what do we do with this information? Great question! There are a few different reasons why a patient may have an outstanding balance or credit on their account, and depending on the situation the steps required to “fix things up” may differ. Let’s walk through a few examples together:

 

🔎 My patient has an outstanding balance, when they shouldn’t be owing this amount.

If a client is showing a private outstanding balance, there are several different possible explanations.

1️⃣ Firstly, this invoice could be outstanding simply because the patient has not yet paid for their invoice. We recommend double checking the Payments tab to review whether a payment was collected for the same day. If not, it’s possible that the payment was not collected OR it was collected but not recorded in Jane (depending on the payment method used).

If necessary, you may need to reference your end-of-day print-outs or deposits to confirm whether or not this payment was collected.

In case you need a quick refresher, here is our walkthrough on Collecting Patient Payments.

If you have a Jane Payments set up for your clinic, you can prompt your client to pay their outstanding balances online.

2️⃣ If you reviewed the patient’s Payments tab and noticed a corresponding payment for the same day, it’s possible that the payment was successfully collected and recorded in Jane, however the payment has not been applied OR has become unapplied.

In this case, you’ll likely see a very similar balance owing as there is credit on the account, suggesting the invoice and payment just needs to be connected together.

Here is our guide on Applying a Patient Credit to a Specific Invoice for the steps on how to apply these payments to the invoice.

3️⃣ It is also possible that there is an invoice outstanding that has been billed in error. Perhaps a patient was going to purchase a product but didn’t. In this case, removing the invoice altogether would make the most sense.

For products, the invoice can be deleted by clicking on the drop-down arrow next to the line item in question:

For appointments, the invoice is generated upon arriving the appointment, so you’ll want to make sure to unarrive the appointment by visiting the schedule and clicking on the green button. From here, you can then proceed to cancel or delete the appointment if appropriate

 

🔎 My patient has a partially outstanding balance and they shouldn’t be owing this amount.

If an invoice has been partially paid, but there is still an partial amount owing, there are a couple of common explanations.

4️⃣ It’s possible that only a partial amount was collected, and the patient actually owes the remaining amount.

5️⃣ Similar to the previous section, it is also possible that the payment was collected in full, but a partial amount was not applied to the invoice, or at some point was unapplied from the invoice. Often, this is a result of applying an adjustment (discount) after a payment has been collected, which changed the final price of the invoice.

6️⃣ Speaking of Adjustments, it’s also possible that the opposite scenario is true too— where a discount was supposed to be applied to an invoice, but hasn’t. For example, a patient is billed $100 for an invoice and usually receives a 15% Friends & Family Discount.

Their usual $85 was collected by the clinic, but since the adjustment had not yet been applied to the invoice, Jane thinks that $15 is still owing. Adding the adjustment onto the appointment should do the trick here.

7️⃣ There may be times when an outstanding amount cannot be collected, so it might make sense to write-off the remaining balance instead.

This will let Jane know that we are no longer expecting to collect for this amount, and zero out the outstanding balance for this invoice.

Here is our guide on Writing Off Amounts (and Reversing Them) for your reference.

 

🔎 My patient has a credit on file when they shouldn’t.

Okay, so now that we’ve covered outstanding balances, let’s take a look at possible reasons why a patient might have a credit on file.

1️⃣ Credit on File is Valid

After reviewing the patient’s Profile > Billing > Payments area, it’s possible that all of the listed payments correspond with actual payments that were collected from this patient. Usually this happens in the case of an overpayment or pre-payment. In this situation, keeping the credit on file is totally acceptable and will be available for the patient to use the next time they come in for a visit.

2️⃣ Payment needs to be applied

As mentioned in the outstanding balances section, sometimes a payment has not yet been applied (or has become unapplied) from an invoice and just needs to be reconnected.

Here is our guide on Applying a Patient Credit to a Specific Invoice for a refresher on how to apply these payments to the invoice.

3️⃣ Payment needs to be refunded

There are occasions where a payment may have been over-collected or collected erroneously. Or perhaps a client has requested a refund for some of the credit on their account. In these cases, it may be most appropriate to refund the patient this credit. The refund process will zero out the account credit.

Here is our guide on Refunding a Payment.

4️⃣ Payment needs to be deleted

If a payment was recorded by mistake, it may make more sense to just delete the payment altogether. This can be done from the payment details page itself by clicking on the trash can icon.

A friendly reminder that the ability to delete a payment is only available to non-Jane Payments payment methods, and may only be accessible to staff members with certain permissions.

5️⃣ Payment needs to be corrected

One final explanation for an outstanding credit may be that a payment was recorded, but for an incorrect amount— we’ve all accidentally added or dropped an extra “0” where we shouldn’t have!

Not to worry, if you are working with a non-Jane Payments payment method, you will be able to Edit the amount that was collected for a payment if the amount value is incorrect.

However, if you are working with Jane Payments, since the transaction took place within Jane you may have to refund an over-collected amount, or process a second payment if the client was undercharged.

🔎 I have a credit memo with an unused amount

It’s worth noting that Credit Memos should only be used in specific situations, where you’d like to add a credit to someone’s profile without recording a payment. Some use cases that might call for this would be:

1️⃣ Transitioning Credits to Jane from another software during onboarding

2️⃣ To represent a trade of some kind – such as $100 worth of products or services for $100 worth of marketing from a friend or client. Since credit memos are not actually payments, they cannot be refunded. However, the following circumstances will help you identify what your next steps might be:

3️⃣ A credit memo was used in error

If you have a credit memo that was added in error, you can delete the credit memo. To do this, you can head to Credit Memos in the Billing area of a patient’s profile. Here, if you View that Credit Memo, you can Delete it.

Note that if this Credit Memo is applied to invoices, you’ll first need to Unapply this Credit Memo from those invoices. The invoices this Credit Memo was going towards will become outstanding.

4️⃣ The credit memo was for the wrong amount

If you have created a credit memo that was for the incorrect amount, when viewing the Credit Memo (Billing > Credit memos > View), you can modify the Amount field to update this.

It’s worth noting that once you apply a credit memo to an invoice, the amount cannot be changed. You can, however, follow the steps above in 3️⃣ to delete the credit memo, and re-add one for the correct amount.

5️⃣ The credit memo should cover additional invoices

If you have outstanding invoices that should be paid using this Credit Memo, you can navigate through a Receive Payment workflow (one such way would be by clicking “Private Outstanding” from their profile) and select the invoices you’d like to be covered by this amount. Then, choose Account Credit as the payment method

6️⃣ The credit is valid

If you have reviewed all invoices and confirmed that they are correct, and reviewed the other payments you have collected from this patient, it might be that this credit is indeed valid. This can happen if patient responsibility changes retroactively — such as a different coinsurance amount for our US folks out there after receiving an EOB!

 

Insurer Owings and Balances

To wrap up this guide, we also wanted to demonstrate how these tips can also be used to investigate outstanding insurer balances and credit as well.

Each insurer has a dedicated folder which can be found under the Billing Tab > Insurer Invoices section on the sidebar.

Just like patient profiles, a summary of any unpaid invoices and available credit will be listed at the top of the page. The option to filter invoices and payments by outstanding are also available to assist with any necessary investigation.

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