WhoFinance users
WhereFinance screen › Encounters list
FirstClick the Episode
The list shows the Episode's last 24 encounters. shows every one; Billable Only hides those with no billable procedure. Each encounter is Not Billed (N) until a claim includes it, then Billed (Y) with the date.
| Item | What it does |
|---|
| Edit / View Encounter | The finance data: procedure, units, charge, billed and paid status, authorization. (The progress note is on the Clinician screen.) Its Secondary Insurance section links the encounter to the secondary authorization — see Secondary insurance below. |
| Remove (Encounter) From Invoice | Takes the encounter off its claim, so it can be billed again (e.g. the carrier asks for a new claim). Refused while it has insurance payments — reverse them first. |
| Flag Not Billed | Back to Not Billed, so it goes on a new claim. Any invoice it is already on keeps it in its record — the encounter's history shows every invoice. |
| Flag Donated | A free service: never billed to anyone. |
| Copy Encounter (Finance data only) | A new encounter with the same procedure, provider and diagnosis, dated today, Not Billed. No progress note is copied. |
| HCFA (for Client) | A claim on the older HCFA 1500 form — works like a new CMS-1500 claim (see Invoices). |
Secondary insurance
An encounter is billed to the client's primary insurance through its Authorization. To bill the balance to a secondary insurance, the encounter must also be linked to the secondary insurance's own authorization (made first on the Clerk screen — see Secondary insurance authorization):
- Click the encounter › .
- In Secondary Insurance, choose the secondary authorization in Auth. Only the Episode's authorizations of a Secondary insurance are listed, never the primary one.
- Billed: No (to be billed to the secondary), Yes (already billed) or Donated (not billed to the secondary). Amount: what the secondary is asked to pay — it starts as the charge minus the payments received. CAS: the adjustment code of the primary payment, if any.
- Click Save. The encounter is now on the secondary insurance's electronic claims (the claim's Secondary choice in AgHipaa).
Date and Invoice show when and on which claim the secondary was billed; once it is on a secondary electronic claim the section is locked (a RollBack of that claim unlocks it). Choose (none) to remove a secondary that was never billed.
Link every encounter to both authorizations. Payments are posted automatically from the carriers' payment files: the 835 file tells whether a payment comes from the primary or the secondary insurance, and PsyTrace posts it to the encounter through the matching authorization. A secondary payment for an encounter with no secondary authorization is not posted (the payment report lists it). There is no need to mark the encounter Partially paid by hand any more.
The client paid the whole fee? So that the insurance is not billed, Edit Encounter and set Billed to Yes — a Client invoice alone does not stop the claim.
PsyTrace checks
- Every change is kept in the audit trail.
- Copy Encounter: refused on a discharged Episode; asks when the authorization has expired.
- Secondary Insurance: the authorization must be one of the Episode's Secondary insurance authorizations and cannot be the primary one; locked once on a secondary electronic claim.