How to Setup Responsibility Percentages.

Each payor can be a primary or a secondary payor for different medical orders. Each payor added to a customer has 2 boxes; Responsibility 1st and Responsibility 2nd. If you change the percentages from 100% then this will split the total amount allowed between the payors in the accounts receivable table. If you do not change the percentages, then the first payor will have 100% of the allowed amounts in the account receivable table.

While the cursor is on Palmetto:

While the cursor is on Colorado Medicaid:

In the above examples, Medicare pays 80% of the allowable as a primary payor. That is Medicare’s standard %. Medicare pays 0% of the allowable as a secondary payor. The customer does not have Medicare as a secondary payor. Colorado Medicaid pays 60% of the allowable as a primary payor. An example of this is if the customer is getting diapers. Medicare does not pay for diapers. On the order, the user will remove Medicare from the order making Colorado Medicaid the primary payor. Colorado Medicaid pays 20% of the allowable as a secondary payor. It is the balance of the 80% that was entered for Medicare.

Note: If a claim has a balance, with a percentage of the allowable for the primary and secondary payor, the secondary payor will not be billed until the primary is paid or adjusted off.

Note: If a claim has a balance, with a percentage of the allowable for a primary and ONLY has SELF as a 2nd payor, the customer WILL be billed before the primary is paid or adjusted off. If you do not want to bill the customer before the primary is paid, leave the responsibility 1st and 2nd at 100%