After Discharge: Hospital Patient Administration

Why Use This Function:

Shifting amounts between the Patient and the Medical Aid involves adjusting which party is responsible for specific costs. This might be done to reflect accurate billing based on coverage details, eligibility, or changes in the Patient’s benefits plan. For example: Medical Aid Denials or Shortfalls: If a Medical Aid partially covers or denies a claim, the outstanding balance may need to be shifted to the Patient. If the Medical Aid didn't pre-authorise a particular service, the amount may initially be billed to the Patient. Once authorisation is granted, the amount could be shifted back to the Medical Aid.

• This user manual will start on the Case Screen - Case Account Tab screen.

• For more information regarding how to navigate to, and how the Case Account screen works, please refer to the user manual: Case Screen - Case Account Tab.

• All Transactions posted on the Case will be listed.

• Double-click on the desired Invoice.

• More Options will become available. 

• Click on the Actions tab.

• The Actions tab will open. 

• Click on the Shift Amounts button.

• The Invoice Shift screen will open.

• Click on the Reason field to enter why the amounts are being shifted.

• Click on the Shift Entire Amount to Medical Aid button to shift all outstanding amounts to the Medical Aid, making the Medical Aid liable for payment of all items.

• Click on the Shift Entire Amount to Patient to move all outstanding amounts to the Patient making the Patient liable for payment of all items.

• Click on the field in the Amount column within the corresponding section and enter the desired value for the specific line to specify the amount for which either the Medical Aid or the Patient is liable.

💡Please Note: To reduce the amount, add a subtract (-) character in front of the value on the side you want to decrease; the opposite side will automatically update to reflect the change.

• Click on the field in the Reason column to enter an explanation for why the amounts are being shifted on the specific line.

• Click on the Save button to save all the changes that have been made.