The following two examples both use the Scheduled Event type of Client Payment application. One has a remainder that results in a change to the Specific Services type of Client Payment application, and both demonstrate auto-applied payments and system-generated Remittances.
Example 1 - Clients with Defined Copays
Raymond Avila and Debra Bailey are scheduled in the same Group Therapy Event.
![Scheduled Group Therapy Event Scheduled Group Therapy Event](/sites/default/files/scheduled_events.jpg)
These two Clients have the following Payer, Account, and Payment information.
Client |
Current Account Balance |
Primary Payer |
Expected Self Pay Charge |
Client Payment Amount |
Raymond Avila |
$0.00 |
837 Payer |
$10.00 Flat Copay |
$10.00 |
Debra Bailey |
$40.00 |
837 Payer |
20% of Base Copay ($30) |
$70.00 |
The $10.00 payment is posted for Raymond Avila, and Scheduled Event is selected in the Apply Payment To section.
![Example Client Payment for Event Example Client Payment for Event](/sites/default/files/avila_client_payment_for_event_0.png)
The $70.00 payment is posted for Debra Bailey, and again Scheduled event is selected with both the Event Date and Event fields populated.
![Client Payment Example 2 Client Payment Example 2](/sites/default/files/d_bailey_client_payment.jpg)
The Clients attend the group therapy appointment, and the Client Payments are reconciled at the end of the day.
![Reconcile Client Payments Reconcile Client Payments](/sites/default/files/reconcile_payments.jpg)
Later that evening, Charges are Created and Finalized for these two Group Event Participants.
![Charges Created for Event Services Charges Created for Event Services](/sites/default/files/charges_created_for_service_events.jpg)
Copay Charges for Self Pay for each Client are calculated during Charge Creation because both have the copay configured on their 837 Payer in Clients > Payer. When the APPLY_CLIENT_PAYMENTS job runs again (typically on the hour), a Ready Remittance is created for each Client, as shown below.
![Auto Created Ready Remittances Auto Created Ready Remittances](/sites/default/files/ready_cp_remittance.jpg)
Note that Debra Bailey's Remittance amount is $30.00 and is the same amount as the Self Pay Charge associated with the event selected when the Client Payment was entered. The total Client Payment amount was $70.00, which means there is still an unallocated Client Payment amount of $40.00 associated with the Group Therapy Event on 10/20/2021. This unallocated amount remains in Pending Status until the Service Status is DONE. Handling the remainder is covered at the end of this section.
These Ready Remittances are included in the next Fiscal Overview > Unprocessed Remittances > Process Transactions job for Self Pay.
![Process Client Payment Remittances Process Client Payment Remittances](/sites/default/files/process_transactions_for_CP_remittances.jpg)
When the Process Transactions job above is finalized, the copays are applied to the correct transaction without any extra steps after collecting the initial payments.
Raymond Avila Claim Details
![Client Avila Claim Details Client Avila Claim Details](/sites/default/files/avila_claim_details.jpg)
Debra Bailey's Claim Details
![Client Bailey Claim Details Client Bailey Claim Details](/sites/default/files/baileys_claim_details.jpg)
The Account tab for each Client is also updated. Raymond Avila's Account tab displays a balance of $0.00, and his Client Payment record now displays the Applied icon.
![Client Avila Client Payment Status Client Avila Client Payment Status](/sites/default/files/avilas_client_payment_status.jpg)
Debra Bailey's Account tab displays a balance of $40.00 but her Client Payment record still has the Pending icon because the full $70.00 Client Payment is not yet applied.
![Client Bailey Client Payment Status Client Bailey Client Payment Status](/sites/default/files/baileys_client_payment_status.jpg)
Payment for the Copay for the 10/20/2021 Service has been fully applied (Client Balance is $0.00 for the highlighted Service below.), but the remainder of Debra's Client Payment, $40.00, stays in Pending Status until the Service Status is DONE. In the example below, the Payer has not yet responded, and the Service Status is still Charge Created.
![Service in Charge Created Status Service in Charge Created Status](/sites/default/files/service_in_chargecreated_status.jpg)
After the Payer responds and the payment is posted with any necessary adjustments, both the Charge Status and the Service Status are updated to DONE, for example below.
![Service in Done Status Service in Done Status](/sites/default/files/service_in_done_status.jpg)
Once the Service is DONE, the next time the APPLY_CLIENT_PAYMENTS job runs, the $70.00 Client Payment's Apply To type is updated from Scheduled Event to Specific Services.
Before Job Runs |
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After Job Runs |
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And the remaining amount is available to apply in the Client Payments > APPLY PAYMENTS screen.
![Client Payment Remainder Available to Apply Client Payment Remainder Available to Apply](/sites/default/files/cp_remainder_available_to_apply.jpg)
When the entire $40.00 remainder is allocated and applied, the Status icon on Debra's Client Account tab is updated to Applied.
![Client Payment Applied Client Payment Applied](/sites/default/files/client_payment_applied.jpg)
Although this example uses Copays defined on the Client's Payer to generate the Self Pay balances, any method of generating a Self Pay balance works provided the Service generating the Charge was created from the event defined on the Client Payment's Apply To section. Some agencies may choose to wait until the Payer responds with payment and then accept the amount the Payer indicates as the Patient Responsibility to waterfall to Self Pay. When this happens, the Client Payment for a Scheduled Event remains in Pending Status until the APPLY_CLIENT_PAYMENTS job runs after the waterfall to Self Pay Create Charges job is finalized.
Example 2 - Waterfall Creates Self Pay Balance
Cassandra Allen has an Anger Management appointment scheduled for 10/21/2021. She pays $20.00 when she checks in, which is entered on her Clients > Account tab and applied to the 10/21/2021 appointment.
![Allen Client Payment Allen Client Payment](/sites/default/files/client_payment_for_sched_event_0.jpg)
The Client Payment is marked Ready and reconciled, and a Charge is created for the Service created from the event. Cassandra's Current Balance is $0.00.
![Allen Balance Before Waterfall Charge Allen Balance Before Waterfall Charge](/sites/default/files/callen_balance_b4_waterfall.jpg)
A Remittance is entered for the created Charge, an amount of $20.00 is entered as the Patient Responsibility, and the Remittance is processed.
![Processed Payer Payment Processed Payer Payment](/sites/default/files/processed_payer_payment.jpg)
Then the Waterfall to Self Pay Create Charges job is finalized.
![Waterfall to Self Pay Job Waterfall to Self Pay Job](/sites/default/files/waterfall_selfpay_job.jpg)
Cassandra's Current Balance on the Clients > Account tab is now $20.00.
![Client Allen Current Client Balance Client Allen Current Client Balance](/sites/default/files/cassandra_20_balance.jpg)
Once the APPLY_CLIENT_PAYMENTS job runs after the Waterfall Charge is Finalized, the Pending $20.00 Client Payment becomes a Ready Remittance.
![Client Allen Ready Remittance Client Allen Ready Remittance](/sites/default/files/cassandra_cp_ready_remittance.jpg)
And the Clients > Account tab immediately reflects this Ready Remittance.
![Client Allen Client Balance and Payment Status Client Allen Client Balance and Payment Status](/sites/default/files/cp_tab_reflects_ready_remittance.jpg)