Re: [Gnumed-devel] Billing/LedgerSMB gap analysis

[Jim Busser]

On 2011-06-09, at 11:52 PM, Chris Travers wrote:

> What I think we'd need to do this with a minimum of grace would be an
> add-on for handling third party payments.  In this model, you'd have
> an additional bill-to contact that would get the first invoice, and a
> second bill-to contact that would get the invoice if declined,
> refused, etc.  For private pay, there would be no additional bill to
> contact.

A fee of $35.00, which could work multiple ways:

1) the bill for $35.00 is sent to the insurer InsurCo who refuses to pay
        --> the bill-to gets changed from InsurCo to patient-pay
        ? does LSMB allow it to be later seen that InsurCo was approached but 
refused? 

2) the bill for $35.00 is sent to the insurer InsurCo who will pay only $25
        --> does this remain a single bill, whose balance is paid by someone 
else?
        or is $10.00 "split off" to make a new bill?

3) it is known in advance that insurCo will pay only $25.00
        --> $10.00 "split off" to make a new bill payable by patient
        --> the remaining $25.00 "is right away billed to InsurCo

Does LSMB already handle the above?

-- Jim