Billing a Patient or Patient Guarantor

This topic explains when you might bill a patient or the patient guarantor.

If the patient is responsible for the charges, you need to send the invoices to the patient, the patient’s insurance carrier, the patient’s guarantor, the guarantor’s insurance carrier, or some other responsible subscriber’s insurance. This process requires that the patient’s account be accurate regarding billing address and insurance plan(s). And if someone other than the patient is the guarantor for the account, then the guarantor’s contact information must be documented as well.

The guarantor is considered to be the emergency contact for the patient, but may not be the subscriber for the applicable insurance. For example, if the patient is a minor child, the guarantor might be the mother with whom the child lives, but the insurance holder might be her ex-husband who lives in another state. In that case, the mother’s ID number should be placed in the Guarantor ID field to ensure that she receives all communications regarding the patient. However the father’s ID should appear in the Alt Subscriber field, to ensure that the appropriate insurance plan information is used for billing.

When you bill from the orders and add a new invoice, the Account ID field will default to the Patient ID. The Responsible Party field will be blank. If insurance is to be billed, enter 1 or 2, as applicable. Account information displays on the right side of the screen. If this information is lacking, go to the Patient Summary screen and add it, if necessary. Then continue through the billing process by adding the charge to the invoice and marking the invoicing complete.