Bill Patients for What They Owe

Once the payers have answered, what is left on a claim is the patient’s to pay. The statement cycle turns those balances into statements, a review queue catches the ones that must not be mailed, and a batch carries the rest to the printer.

Before You Start

You need the User role, a client licensed for statements and work queues, and patient balances on the ledger. The cycle bills what Transactions shows against patient responsibility; with nothing owed, it has nothing to do.

Run the Cycle

1. In the sidebar, select Statements.
2. Select Run statement cycle. The button greys and says the cycle is running, and a banner above the list says when it started.
3. When the banner clears, read the tiles. Held counts what the cycle stopped and Ready to send counts what passed.

Result: every account owing at least the minimum, and not billed within the cadence, has a new statement: Ready if it passed the check, Held if it did not.

If the list says no cycle is scheduled, the button still runs one with the defaults: a $5 minimum and 30 days between notices. An Administrator sets the policy by scheduling the Generate Statements task on Schedules.

Release What Was Held

1. In the sidebar, select Work Queues.
2. Open the queue named Statement Review.
3. In the Work Items rail, select an item. Each is labelled with the statement number, its amount and how many holds block it. The workspace shows the Holds and Bill to cards, with a note where the document would be.
4. Read each hold. An address hold is fixed here. A restriction hold links to the patient’s card. Every other hold names a reason not to bill that lives outside the statement.
5. Optional: for an address hold, select Edit bill-to and complete the address.
6. Optional: select Save Bill-To. Saving re-runs the check, and the address hold clears.
7. Optional: for a restriction hold, select Manage restrictions, end the restriction on the patient’s card if it no longer applies, and return to the item.
8. Select Release. Release re-runs the check rather than trusting what you saw. If an error still holds the statement, ClaimPod refuses, says how many, and stays put.

Result: the statement is Ready, leaves the queue, and the processor advances to the next item.

Caution

A statement held for a payer still adjudicating has nothing to edit on the item. Either leave it and select Release again once the payer answers, or open it with Open Statement from the item’s menu and void it there; the balance stays on the account.

A restriction that still applies is not something to release around. Leave the statement held, or void it; a QMB restriction in particular means the balance is not the patient’s to pay.

Send the Batch

1. In the sidebar, select Statement Batches. Statements Ready counts what the batch will take.
2. Select Create Batch. The dialog says how many statements are ready and their total.
3. Optional: in Deliver to, choose a connection. Download only keeps the files on the batch page. A connection also pushes them into its output folder for the mail house to collect.
4. Select Create Batch to confirm. The batch appears as Pending, and its page updates itself while it generates.
5. Open the batch.
6. Select Download PDF Bundle. One PDF, every statement in mailing order.
7. Select Download Manifest. One CSV row per statement, for the mail house.

Result: every included statement is Sent, and Sent this cycle on Statements counts it. Anything excluded stays Ready and rides the next batch, with the reason on the batch page.

Why Some Statements Are Held

The cycle checks every statement it makes against ClaimPod’s own holds and the client’s rules at the statement generated trigger, and holds anything an error touches. The Statement Page lists every hold and where its fix lives.

Related: Statements · Statement Batches · The Queue Processor · Work a Queue Item · Import Patient Payments