RevNet User Guide - Balance Forward

How Do I.....Balance Forward an Invoice?

After an invoice has been billed and partially paid by a Primary Payer, the remaining balance can be sent to a secondary payer (or tertiary payer after a secondary payment). There are a number of ways that a remaining balance can be sent to a subsequent payer. They include:

   

Cross Over from Medicare

Automatic Balance Forward During Cash Receipt Close

Manual Balance Forward from Account Inquiry

Manual Balance Forward from A/R Management

Cross Over from Medicare

When Medicare knows the coordination of benefits (COB) for a patient, they will automatically cross over the remaining balance to the secondary payer. In situations like this, the secondary payer does not need to receive an invoice from the provider, because they have already been sent the information from Medicare. When Medicare does this process, the information is included in the ERA file.

   

When this information is seen in the ERA File, RevNet will create the secondary invoice and mark it as billed. This will prevent the invoice from being balance forwarded.

Payer Setup

   

Navigate to Setup -> RevNet -> Payer/Provider -> Payer -> [Select Payer] -> EDI Settings.

   

In order for the process to happen automatically, the secondary payer must have the Cross-Over Payer IDs selected.

   

Cross-over Claims to Review

If the payer is not set up or if Medicare creates a new Payer ID, these will need to be manually updated from the Cash Receipts Page.  

Navigate to A/R Mgmt -> Cash Receipts.

   

A warning will be displayed when there are Cross-over Claims to review. Click the link to show the cross-over claims.

   

   

Select the appropriate RevNet payer from Select Payer, based on the description on the Cross-over Payer and press [Enter].

   

   

Automatic Balance Forward during Cash Receipt Close

If the Payer is not Medicare or the COB information is not known, the invoice can be balance forwarded when the Cash Receipt with the payment is closed. Once all payments have been posted and the balance is 0.00, click Close Receipt.

The Close Receipt page will show all invoices that have an outstanding balance. If the Next Payer for that patient/invoices is known it will appear in the Next Payer Defined section. If the Next Payer is not known, it will appear in the Next Payer Not Defined section. This allows for selecting the Next Payer for that invoice. Once selected and saved (by pressing [Enter]), it will appear in the Next Payer Defined section.

   

Choose invoices to balance forward to the next payer by checking the box and then clicking Close Cash Receipt and Process. This will create the next invoice and send it to Billing Verification or Batch Processing as needed.

   

   

Manual Balance Forward from Account Inquiry

Navigate to A/R Mgmt -> Account Inquiry.

   

Filter Account Inquiry for the invoice. Use the Action Item List and select Balance Forward.

   

   

Select the Next Payer from the drop down list and click Balance Forward.

   

   

The invoice will be created and sent to Billing Verification or Batch Processing.

   

Manual Balance Forward from A/R Management

   

Navigate to A/R Mgmt -> A/R Management -> Detail

   

Filter A/R Management for the invoice. Click to open Claims Edit.

   

   

In Claims Edit, click Balance Forward.

   

   

Select the Next Payer from the drop down list and click Balance Forward.

   

   

The invoice will be created and sent to Billing Verification or Batch Processing.