ClinNext™ Patient Accounting and Billing Management

ClinNext's on-line, real-time patient accounting and billing management processes begin with the registration of the patient. The Registration Module works in conjunction with the Appointment Scheduling Module. If an appointment existed, the patient record is retrieved (either alphabetically, partially alpha or by S.S.N.) and the latest patient data along with the services scheduled are displayed to the registration clerk. During the registration process, a number of different hard copy outputs occur, as well as the ability to scan patient documents (e.g. Patient Insurance Card, Drivers License, Consent forms, etc.). The Registration Module also drives an addressograph machine at larger clinic sites.

After the provider performs and records the services, the encounter entry process takes place as the patient leaves the health center. This process includes capturing the service(s) information, such as diagnoses, provider information and other relevant information. All of the service, diagnosis and provider coding is validated on-line against a number of different files.

If private billing (based on the patient's status) is justifiable, a billing display is automatically presented to the out patient clerk and the patient. A sliding fee computation may automatically be included and the display also reflects prior uncollected dollars owed. Patient payment data is recorded (if any) and the patient is supplied with an on-demand bill/receipt. If insurance billing is involved, the system generates billing forms (HCFA 1500, UB92’s etc) for the insurance company.

One of the largest, most complex modules within the system is the Centralized Billing and Electronic Cash Remittance functionality. Medicaid and Medicare billing are consolidated on pre-determined billing cycle schedules for all health centers. The billing and cash remittance processes are accomplished via electronic transfers. This module also maintains an on-line accounts receivable file for each facility. Users have immediate access to the status of each patient. Electronic remittance is also an integral part of the system.

Using advanced workflow-based design, this module streamlines and automates the billing process from registration to final payment. It was designed to accommodate any Insurance company and its billing processes. This module makes the registration process more efficient, it enables the user to scan patient’s documents and immediately captured them in an electronic format.

Integration with our Clinical and Financial Repository allows access to a powerful analytical tool to manage your business as it happens, and not from yesterday’s paper reports.