Setting Up Self-Pay

• A Self-Pay Client Payer is only required if the Client will owe something.  Unlike RevMan, all Clients in EchoVantage do not need to have a Self-Pay Payer. Clients who should never owe any balance should not have a Self-Pay Client Payer.
• Multiple Self-Pay Payers can be configured, but a given Client should only be assigned one of them at a time. At no time should a Client have 2 Self-Pay Client Payers billable to the same services at the same time.

Copays vs. Client Fees

• A Copay is something the Client owes to the agency based on what the Payer requires the Client to pay. As soon as the service is processed, Self-Pay will have a charge for that service equal to the Copay amount.
• A Client Fee is a means by which the balances that waterfall to Self-Pay may be reduced. The Self-Pay charges and the adjustments to them will be calculated when the balance waterfalls from the last Commercial Payer to Self-Pay.

What if Two Client Payers both have Copays?

• Echo’s rule for conflicting Copays has always been to use the one that is processed first in the waterfall. 
• If a Payer 1 has a Copay, that is the fee that the Client will owe, regardless of any other Copays or Client Fees.

Patient Responsibility

Versions 3.18 and above

• A Patient Responsibility amount may be entered with a Payer’s payment.
• When the agency wants to (or is willing to) accept whatever the Payer says is the Client Fee, the Patient Responsibility amount should be entered.
  • When a self-pay charge does not already exist, the amount entered for the Patient Responsibility creates an equal self-pay charge, regardless of any other Client Fee, Sliding Fee, or monthly Maximum.
  • When a self-pay charge does exist and the amount entered in the Patient Responsibility is greater than the existing self-pay charge,
    • The amount entered as Patient Responsibility shows as a FEE ADJ to that Payer.
    • And the system calculates and applies a CHARGE INCREASING CREDIT to adjust the self-pay balance to the amount entered as the Patient Responsibility.
    • This is the self-pay charge regardless of any other Client Fee, Sliding Fee, or monthly Maximum.
  • When a self-pay charge does exist and the amount entered in the Patient Responsibility is less than the existing self-pay charge,
    • The amount entered as Patient Responsibility shows as a FEE ADJ to that Payer.
    • And the system calculates and applies a FEE ADJ to decrease the self-pay balance to the amount entered as the Patient Responsibility.
    • This is the self-pay charge regardless of any other Client Fee, Sliding Fee, or monthly Maximum.

Versions 3.17 and below

• A Patient Responsibility amount may be entered with a Payer’s payment.
• Patient Responsibility should be used when:
  • No prior Copay has been charged
  • You want to (or are willing to) accept whatever the Payer says is the Client Fee, regardless of your agency’s policies on sliding fees.
• Whatever amount is entered for the Patient Responsibility becomes the Client balance, regardless of any other Client Fee, Sliding Fee, or Monthly Maximum.