This guide will cover how to post Capitation payments into the billing software.
Note: this method can also be used to track payments like Prop 56. The important thing is to, when creating the Patient and Code, use selections that you'll remember and use consistently.
Handling A Patient's Capitated Claim
You can Settle the patient's claim to Capitation for clerical purposes!
Posting a Capitation Payment
Step 1 - Create a "[Payer] Capitation" Patient
If you're posting your first Capitation payment from a payer, create a new Patient, listing
the Payer as the First Name
Capitation as the last name
DOB and Sex can be whatever you want to list - these fields are required when creating a patient file, but will have no bearing on the Capitation Posting process
Step 2 - Create a Superbill for [Payer] Capitation
Create a new Superbill for the Payer you're posting for.
The From and To dates should match the date of the check.
When it's time to Add Claims, use a custom code that you'll use across all capitation payments (for example, "CAP").
Enter the value of the check within the CHG field.
Step 3 - Add the Superbill to the Capitation Payment
After creating the Payment for the Capitation (click here for instructions on creating a payment), add the capitation Superbill to the payment, and apply the payment to the superbill.