Gross and Net Billing

If you haven't already done so, please be sure to read Billing Overview and Fee Schedule Overview prior to reading this topic.

Summary

Most medical billing systems are limited in their ability to handle pricing and discounting with the level of flexibility required in an occupational health setting. In addition to being able to handle pricing overrides and discounts . The program also provides a unique feature that allows you to choose how to print prices and discounts on invoices and whether to carry the undiscounted or discounted prices in the Accounts Receivable.

Undiscounted prices from a fee schedule are referred to as gross prices . In the software, you can choose to print the gross prices on Employer service , Workers Comp and/or Private Practice Visits that are provided to an individual patient and paid for either by the patient (employee) him or herself, or by their group health insurance carrier. invoices, in which case the gross prices are carried in the Accounts Receivable. When you use gross pricing, any discount, whether from a discount percentage or an override price, is carried in the A/R along with the gross (list) price, and will display as an expected or allowed discount during cash application. The A/R Aging reports can be run to show both the actual and the expected (net realizable) amounts due. Gross pricing is normally chosen for both Workers Comp and Private Practice billing, primarily because insurance carriers will often take discounts from the amount showing on the invoice.

Discounted and override prices are referred to as net prices . If you elect to use net pricing, the invoices will show the net (discounted) amount due, and only the net amount will be carried in the Accounts Receivable The ledger of billing accounts, including specific invoices and amounts that are owed to the provider organization. From an accounting perspective, the Accounts Receivable is a sub-ledger of the general ledger. For that reason, strict accounting controls are used in STIX to maintain the integrity of Accounts Receivable and comply with generally accepted accounting principles (GAAP). . This is the recommended pricing method for Employer Paid services. When you elect net pricing for your Employer Paid services, you can tell the software to show the discounts provided on the bill. However, the discounts will be excluded from the A/R.