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Policies,Administrative,UWMF,UWMF-wide,Patient Business Services

On-Site Payments (aka Cash Management) (113.020)

On-Site Payments (aka Cash Management) (113.020) - Policies, Administrative, UWMF, UWMF-wide, Patient Business Services

113.020

PBS – 4: On site payments
9-15-07
1

University of Wisconsin Medical Foundation
Patient Business Services Policies & Procedures
ON-SITE PAYMENTS
(aka Cash Management)


__ __ New __X__ Revised

If Revised, Supersedes Policy Dated: 12-1-03, 2-
01-05, 2-10-06

Effective Date: 9-15-07


Policy Number: PBS – 4
Approved By (Name): Connie Kinsella, Vice President, Patient Business Services


Purpose

To define the process for taking in and managing cash, check and charge card payments received
at clinic sites. Clinic receipt of patient and other payments must be forwarded to the Finance
Department-Deposits on a daily basis for deposit to UWMF bank account.

Policy

PAYMENTS
1. Every effort should be made to collect patient copayments at the check-in. Posting of
copayments will be done in Epic at the clinic location at the time payment is received.

2. Payments on outstanding patient balances will be accepted on-site.
 Payments made on Epic balances should be posted using the Other Payment functionality
in Epic (described below).

3. In the event that an insurance payment is misdirected to a clinic site, the envelope containing
both the check and documentation should be placed in the BLUE DEPOSIT BAG and sent
to the Finance Department-Deposits. Do not post to Epic or record on payment log.


CASH MANAGEMENT
1. There will be one payment cash drawer for each clinic or payment location.

2. It is recommended that each patient payment cash drawer maintain a beginning balance of
$50, $100 or $200, depending on the volume of patient payments. The beginning balance
should be the minimum amount needed to make change early in the shift. If a clinic manager
determines that the cash balance needs to be increased, please contact the Finance
Department-Deposits and state in writing or in an e-mail the reason for the increase.


PBS – 4: On site payments
9-15-07
2
3. Physical access to cash,the cash drawer, money envelopes and deposit bags should be limited
to authorized personnel – receptionists or registration/check-in staff (at sites with such staff)
and clinic managers (or another person as designated by the clinic manager).
 Clinic managers should periodically evaluate that only essential employees have access to
cash.

4. The cash drawers, money envelopes, deposit bags and payment receipts are to be maintained
in a secure environment at all times:
 During clinic hours, keep in an area that is out of reach of unauthorized persons, including
patients.
 Store in a locked drawer or cabinet when clinics or payment locations are closed.

5. Cash drawers and deposit bags must be stored separately from the access keys. Only the
clinic manager, registration staff and limited designated personnel should be aware of where
keys are stored.

6. Patient payment cash drawers are only to be used for the storage of patient payment cash and
not used to secure other items of value (e.g. postage stamps).

7. Patients, employees and physicians may not cash personal checks or break-down large bills
via the patient payment cash drawer. Likewise, payments made by check, money order,
travelers checks or credit/debit card may not exceed the amount of payment taken.

8. Patient payment cash drawers and money envelopes must be reconciled as described in a
later section of this policy. If variances are identified, immediately inform your supervisor
and Finance-Deposits. Report the overage or shortage on the Cash Replenishment form and
provide Finance with an explanation for the discrepancy before a check is issued to replenish
the cash drawer. An Incident Report Form must also be submitted if theft is suspected.

9. Proper segregation of duties must be in place. Individuals collecting patient payments or
preparing the Payment/Daily Reconciliation Log must not have the authority to write off
account balances or be involved in accounts receivable, accounts payable or general ledger
functions.


Procedure

Beginning of Each Day:
1. Count the amount of cash in the patient cash drawer:
 If the beginning amount is correct, indicate this on the Payment/Daily Reconciliation Log.
Include the date, site name, site number, beginning balance, time, and your initials.
 If the beginning amount of cash in the cash drawer is something other than the designated
beginning balance, immediately inform your supervisor and Finance-Deposits. In
addition, you must report the overage or shortage on the Cash Replenishment form and
provide Finance with an explanation for the discrepancy before a check is issued to

PBS – 4: On site payments
9-15-07
3
replenish the cash drawer. An Incident Report Form must also be submitted if theft is
suspected.

2. Provide each registration/reception employee receiving patient payments with their own
money envelope:
 Each employee keeps all payments received in their own money envelope, including cash,
coin, checks, charge card slips, money orders, travelers’ checks, etc.
 Registration staff should only use the cash drawer if sufficient cash isn’t available in their
money envelope to make change.



EPIC Payments Received
1. Copayments
A. General Comments
 “Copay Due” will only show for patients covered by a Unity, PPIC, or GHC plan.
This is because only those plans have had copay information loaded into the Epic
benefits engine.
 The “Copay Due” will show for a Unity, PPIC, or GHC patient based on the
appointment type booked. In general, only office visits show a copay due. Prenatal
visits, surgical follow-ups, well-child checks, etc. do not require a copayment. If
these types of visits have been booked using an office visit appointment type, the
system will assign a copay even if one is not due (ie., the system doesn’t know it’s
not really an office visit). In these cases, override the “copay due” field by entering
$0.00.
B. Recording the Copay
 After highlighting the appointment on the DAR, click “check-in”. At the check-in
screen, if the patient has a co-pay due (based on his/her plan and the visit type
booked), the amount due will be listed in the “copay due” field.
 Collect the co-pay and record the amount received in the “copay paid” field.
 Click on the ellipsis in the “payment source” field and select the payment method.
 Click on the ellipsis in the “copay type;” office visit will automatically populate this
field.
 In the reference field:
 Type the check number if the patient paid by check. Only enter the check number
in the reference field (e.g. enter 1278 and not #1278 or number 1278).
 Type the authorization number if the patient paid by credit card.
 If the patient paid by cash, this field should be left blank.
 Click accept. A box will pop up indicating the printer the receipt will be printed at.
Click accept. A second box (and possibly third, depending on your system set up and
procedures) will pop up indicating the printer the labels and/or encounter form will be
printed at. Click cancel.
C. Recording Payment for Past Copays
 Follow the procedure for “payments on outstanding balances” described below.

2. Payments on Outstanding Balances

PBS – 4: On site payments
9-15-07
4
A. Click on the Registration tab that’s located on the most upper toolbar on the Epic desk
top (NOTE: It’s important that you click on the appropriate Registration tab as
indicated above).
B. Enter the patient name or patient ID number in the patient lookup display.
C. Highlight the appropriate patient name and click Accept.
D. Highlight the appropriate contact date that corresponds to the appointment date and click
accept.
On the check out screen, click on $ Other Payment button. This will take you directly to
payment screen.
1. Click on “other payment”.
a. In the “paid” field, enter the amount paid.
b. Pass by the “payment code field (it should automatically populate with “patient
payment”).
c. Click the ellipsis in the “post method” field and select #6, “For Later
Distribution”.
d. In the source field, select the appropriate payment method (e.g., cash, credit card,
check).
e. In the reference field:
i. Type the check number if the patient paid by check.
ii. Type the authorization number if the patient paid by credit card.
iii. If the patient paid by cash, this field should be left blank.
f. Clinic accept. A box will pop up indicating the printer the receipt will be printed
at.

3. For all Payments Received:
 If the payment was made by Credit or Debit Card:
 Only Visa and MasterCard are accepted.
 Verify the expiration date of the card.
 Swipe the card through the electronic terminal. Verify that the payment receives
appropriate card authorization. Obtain the patient’s signature on the credit card slip
generated by the terminal and give the “customer copy” to the patient. Retain a
second copy of the receipt and place in money envelope.
 Imprint machines are located in all clinics for use when the swipe terminal is not
functional. Obtain the patient’s signature on the credit card slip; give the “customer
copy” to the patient, place the remaining copies in the money envelope.
 If the payment was made by check:
 Remind patients to make check payable to “UW Health – Physicians”.
 Verify the check is filled out correctly (payee, amount, date and signature).
 Endorse check immediately.
 Place in money envelope.
 If the payment was made by cash, do not place the cash in the money envelope until after
you and the patient have each confirmed that the proper change was given.




PBS – 4: On site payments
9-15-07
5
Insurance Payments:
1. If an insurance payment is misdirected to a Clinic, place the envelope containing the check
and the accompanying EOB in the blue deposit bag. Do not post on Epic or record on
payment log.

Outside Income:
1. If outside income is received by a clinic (for example, payments for copies of medical
records), place the payment in the blue deposit bag. The payment should be recorded in the
“outside income” section of the payment log, but not counted with the reconciliation.

Reconciliation - Shift Change (mid-day and end-of-day):
1. Each registration/reception employee must reconcile their money envelope to their Epic
report:
 Count the amount of cash, checks and charge card receipts in the money envelope.
 Initial the Epic report by each payment category (cash, checks and charge cards) if they
match the amounts counted in the money envelope.
 Place patient payments in money envelope.
 Fold the Epic report around the money envelope with payments inside.
 Place Epic report and payments in blue deposit bag. Finance-Deposits will return money
envelopes to be used again.
 Immediately inform your supervisor and Finance-Deposits if a variance is identified.

2. The cash drawer should be reconciled at each shift change to verify that it still contains the
beginning balance:
 Indicate the time of reconciliation on the payment reconciliation log.
 If the cash drawer balance does not match the beginning total, each employee should
verify the payments in their money envelope match their Epic report (including employees
whose shift is not ending).
 Immediately inform your supervisor and Finance-Deposits if a variance is identified.

End of Each Day (Reconciliation and Daily Deposit):
1. Each registration/reception employee must reconcile their money envelope as described in
the Shift Change section.

2. Patient payment cash drawers must be counted and reconciled at the end of each day :
 Verify the end-of-day cash drawer balance matches the beginning balance.
 Enter the amount on the payment/daily reconciliation log and initial.
 Another employee should verify the cash drawer balance and initial log.
 Place payment/daily reconciliation log in blue deposit bag.
 Immediately inform your supervisor and Finance-Deposits if a variance is identified.

3. Charge card terminal:
 Set terminal to “UW-Health” (not Medifax). Transaction data will not transmit to the bank
if the terminal is set to Medifax at the end of the day.
 Indicate the patient MRN on the charge card slip.
 Print out daily batch report (function 5 #3).

PBS – 4: On site payments
9-15-07
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 Place charge card terminal daily batch report in blue deposit bag.

4. The secured Blue Deposit Bag, accompanied by a Daily Deposit Routing Control form, must
be forward to the Finance Department-Deposits on a daily basis. The blue deposit bag
should contain the following:
 All Epic reports folded around money envelopes containing patient payments.
 Cash drawer payment/daily reconciliation log.
 Charge card daily batch report.
 Insurance payments and outside income.

5. You will be contacted by Finance-Deposits if a discrepancy is identified. If the problem can
not be resolved via email or phone the deposit may be reported to the clinic in the blue
deposit bag for research. In this case, the Daily Deposit Routing Control form will be
attached with a note “return to clinic”.


Attachments
Cash Exchange
Payment/Daily Reconciliation Log (Excel Spreadsheet)


References
Retail Payment Policy
Prepayment Policy