Skip to main content

Family Statement - PM

  1. Last updated
  2. Save as PDF

You can generate a self-pay statement for family members using this form. It gathers (or compiles) self-pay service information for the family into a file. After it is compiled, the file can be printed or deleted.

Unbilled services can be added to a claim using the Attach Unbilled Service To A Claim form.

Prerequisites:

  • A family must be created in the Family Registration form.
  • Liability must be updated, and charges closed in order to create a claim (Close Charges form).
  • Self pay payment information must be setup for the facility (Facility Defaults form).

  1. Go to: Avatar PM > Billing > Bill Production > Family Statement

  2. In the Print Charges Thru field, enter the last date of service to be included in the statement.

  3. In the Create Claims Y/N field:

    • Select Yes to generate a claim for the services. A service cannot be claimed more than once, unless the claim has been deleted.

    • Select No to compile the claims into a file without creating a claim. This can be done multiple times. 

  4. In the Date Of Claim field, enter the date.

  5. In the Guarantor # field, enter the guarantor name, and select.

  6. In the Individual Or All Families field:

    • Select Individual to compile claims for one family.
    • Select All to compile claims for all families.

  7. In the Family ID field, enter the family ID, and select.

  8. In the Exclude Clients With Self-Pay Balances Less Than field, enter a dollar amount to exclude families form the self pay statement. Families with a balance less than this amount will not be included in the family statement.

  9. In the Program(s) field, select the programs to limit the services listed in the family bill. Services associated with that program are included in the bill compile. Selecting no programs includes services from all programs in the bill compile.

  10. Click Compile Family Statement to compile family service information.
    Result: After the compile is completed, the family statement can be printed (Print Family Statement section).

► Registry Settings

  • 837I-Dates To Populate 2300 DTP

  • Display Individual Payments

  • Display Payments Thru Print Charges Thru Date

  • Include Bill Report Selection

  • Include Non-Billable Services

  • Include Zero Charge Services

  • Limit Family Statements To Monthly

  • Limit Self Pay Bills To Monthly

  • Number Of Days For Due Date Calculation

  • Number Of Days Override

  • Pay Arrangement Includes 0 Charge Pymt

  • Print Bills Only For Discharged Client

  • Print Claims With Credit Balances

  • Self-Pay Bill - Services To Include

  • Use Claim First/Last Dates Of Service

  • Use Coverage Effective/Expiration Dates