Ledger Tab Overview
The Ledger can be divided into three main areas, and several sub-areas. The ledger is most obviously used for accounting and adding transactions for your patients, but it can also be used to view clinical information.
Incident Sidebar
The Incident Sidebar displays all unarchived incidents for the patient, as well as the Treatment Plans Folder and Account Ledger (which contains transactions for all patients on the account). Above the incident list is the Incident Menu, which can be used to create, archive, retrieve or delete incidents.
Treatment Plans
The Treatment Plans node in the Ledger sidebar is generally used as a quick view of all existing Treatment Plans.
The Treatment Plan Status can also be adjusted here. If the cursor is moved next to the status, an x will appear. Clicking the x will hide the treatment plan from this view but will not remove it.
Account Ledger
The Account Ledger is a list of all Ledger activity in a single account. You can expand the Account Ledger and select the individual Patient to view all of their transactions on one place.
You cannot post, open or delete a payment/charge in this area. If you attempt to preform one of these actions while in the Account Ledger, you will be taken to the incident associated with the item, and the transaction will be highlighted.
The Account Ledger is also the only place where you will be able to see Finance Charges on the account, because a finance charge is applied to the account as a whole, not a specific incident. Typically, the finance charges are based upon the Provider/Office selected in the patient's Account tab; however, these may be overridden by double clicking and editing directly on the patient's Account Ledger.
Incident
The Incident allows users to separate a patient's transactions by date, type of procedure, reason for visit, or any number of criteria.
When selected, the Incident will display the Incident Tabs on the right side of the screen. These tabs are used to add more details regarding the selected incident as well as adding additional information on claims.
Once you expand the incident you can select the Contract Billing (if any), Transactions and Treatment Plan for that incident.
Transactions Table Columns
The Transaction Table is a series of columns that contain all of the financial information within the selected incident.
Above this table are the Charges, Payments, Other, Print and View Options menus. Each menu contains several difference functions. You can also customize the Ledger Colors for the transactions to whatever makes sense for your office.
Columns can be dragged and dropped into any order desired. So yours may not match exactly with the order displayed. We recommend dragging the columns that you would want to reference quickly to the left, this will prevent unnecessary scrolling. Not all columns will be used.
Audit ID
This is the User ID of the MacPractice user who entered the line item. A User's ID is defined in the References Ability > Users.
Posted Date
The date the transaction was posted in the Ledger. This cannot be edited.
Proc. Date
The date the item was performed. This can be edited in the original transaction (such as in the charge window for a Procedure's Date).
Code
This column will include the Procedure Code or an identifying short description of the transactions.
Description
The description of the transaction will be shown in this column. For Procedures, it will include the Procedure Description in the Charge Window.
Provider
This column will show the Provider selected within the transaction.
Status
The status of a claim.
Discount
If a discount is set in the Account tab, the amount of the discount appears in this column.
Debit
This is the amount of money charged to the account. Debit items will inflate the balance.
Credit
This is the amount of money subtracted from the account. Credit items will decrease the balance.
Write-Off
Any applicable Write-Off appears is this column.
Balance
This represents the balance as of the placement of the line item. This may not match the Acct. Balance.
Payment Amount
This is the total amount of a payment regardless of what may or may not have been applied.
Open
This will display the amount of money still owed for the line item.
Insurance Portion
This column shows amount of the charge that is estimated the insurance company will pay based on how the user has set up Insurance Estimating. Otherwise, when a claim is created without Insurance Estimating, MacPractice assumes 100% will be paid. The remaining amount after the payment has been applied will go into Patient Portion.
Patient Portion
This will display the amount of the charge that is the patient's responsibility to pay.
Patient Paid
This column displays the amount that a patient has paid toward the line item.
Insurance Paid
This will show the amount that an insurance company has paid on the line item.
In Collection
This will say "Yes" or "No" depending on the collections status.
Collection Transmittal Number
This column displays a Transmittal Number that correlates to submitted Collections in the Collections Manager.
Unapplied
This shows how much of a payment has not been applied to a charge or refunded back to the patient/provider/insurance.
Form Amount
This column shows the total amount of all charges tied to the claim/statement on that line.
Thru Date
This column will show the To Date from the New Charge window.
Units
The number of Units entered in the New Charge window for that specific procedure.
Diagnosis 1-4
These columns will indicate the Diagnosis codes (if any) that were listed in the New Charge Window for the procedure.
Emerg.
This states "Yes" or "No" if the Emergency box in the New Charge window has been checked.
Accept
This column will show "Yes" or "No" depending on if the Provider Accepts Assignment on a claim item. For other items, this column will be blank.
Ins. Plan
This displays the Insurance Plan associated to the claim line.
Ins. Holder
This shows the primary person who holds the insurance.
Fee
This column is the amount charged for the Fee alone.
Fee Tax
This is the amount charged for the tax associated with the Fee.
Is Lab
If Requires Lab is checked in the New Charge window, this column will say either "Yes" or "No".
Lab Fee
This is the amount charged for the Lab. (Canadian only)
Lab Tax
This is the amount charged for the tax associated with the Lab. (Canadian only)
Lab Cost
This will display the Lab Cost as designated in the New Charge window.
Lab Place
This column will show the Lab Name the lab was preformed based on the lab selected in the New Charge window.
Original Fee
This will display the base fee of the charge before any added discounts or fees.
Schedule
This column will show the Fee Schedule selected within the New Charge window for the line item.
Time
This displays the Schedule Units entered in the New Charge window.
Procedure Type
This column will display the Procedure Type set in the New Charge window.
TOS
This pulls from the Type of Service field in the New Charge window. This column is precent in DDS, however it cannot be edited.
POS
This information pulls from the selection a user made in the New Charge window under the Place of Service field.
Tooth and Surface
*Not present in MacPractice DC or 20/20*
These pull from the Tooth and Surface fields in the New Charge window.
Quad
This will pull from the Area of Oral Cavity selection the user made in the New Charge window.
Record #
This is the number automatically assigned to the item chronologically in all of MacPractice. This number cannot be edited or changed in any way, and is generally used in the back end of MacPractice to keep the records in order.
Claim Number
*New in Build 11.6.12+*
A system-assigned number to each Claim. These end in E or P, and indicate whether the claim in question is an Electronic claim or a Paper Claim.
Pri. Deductible
This column will show the amount pulling from the deductible primary insurance. This number will be calculated based on how you've setup your Insurance Plans and the Deductible amount entered in the Patient ability > Patient tab > Insurance sub-tab.
Sec. Deductible
This shows the amount pulling from the deductible secondary insurance. This number will be calculated based on how you've setup your Insurance Plans and the Deductible amount entered in the Patient ability > Patient tab > Insurance sub-tab.
Balance Overview
Below the Transactions Table is the Balance Information. This will give you a quick summary of the totals of the entire account.
Acct. Balance
This number is the total unpaid amount that is owed on the account.
Ins. Portion
This number is the total amount estimated to be owed to the Account from Insurance. If multiple Patients exist in the Account, this number will most likely not match one Patient's balance.
This is based on a couple of different factors.
The way plans and charges are setup with Insurance Estimating. If Insurance is estimated to cover a specific amount, that amount will be reflected in the Ins. Portion.
Any unpaid open claims without Insurance Estimating will show the total amount unpaid in the Insurance Portion. Upon payment, the remainder of the amount owed will transfer to the Patient Portion.
Information on how the Portions will break down can be found in the Portion Troubleshooting table.
The Insurance Portion is also included in the Aging Table below. The first column will show the Balance Total for the Insurance Portion. Then the total will be broken down by 0-30 Days, 31-60 Days, 61-90 Days, 91-120 Days, and 120+ Days.
Pat. Portion
This number is the total amount estimated to be owed to the Account from the Patient or Patients on the Account. If multiple Patients exist in the Account, this number will most likely not match one Patient's balance.
If Insurance Estimating is used, this number will reflect what the Patient is most likely to pay based on the details entered into MacPractice.
The Patient Portion is also included in the Aging Table below. The first column will show the Balance Total for the Patient Portion. Then the total will be broken down by 0-30 Days, 31-60 Days, 61-90 Days, 91-120 Days, and 120+ Days.
Unapplied
This is the amount of payments that have been posted to the Account but not yet applied to any charges. This number will appear in red if it is any amount except $0.00. Unapplied payments will appear in the Transactions Table for every Patient in the Account, but may be intended for a charge on a specific Patient's Ledger.
Primary Coverage
This number reflects the cost that insurance is expected to cover in a year. This number is set in the Insurance tab of the Patient Ability. Insurance payments will cause this number to decrease (so if Insurance pays $100, then $100 will be removed from the Primary Coverage). The number will also decrease if Insurance Estimating is used. This serves to keep an estimate of how much an insurance company is likely to pay on the patient's behalf.
This does not take into effect any service the insurance may cover outside of the office if it is not kept track of in the office's Ledger.
If no Insurance Plan is set for the Patient, then "No Insurance Plan" will appear. Once a Plan has been applied, the Primary Coverage will appear in blue text.
If multiple Insurance Companies are used by the patient, this number will only reflect the Primary Coverage from the Primary Insurance (or the Insurance Company listed on the top of the Patient's Insurance tab.)
This will only apply to the selected Patient. If there are multiple Patients on the Account, another Patient will need to be selected in order to see their Primary Coverage.
Deductible
This is the Deductible that the patient will pay based on their Insurance carrier. Similar to Primary Coverage, this number is set in the Insurance tab of the Patient Ability. A Deductible is applied if the Charge has a Procedure Type that is designated Applies to Deductible in the Plans tab inside the Insurance Company Reference.
If no Insurance Plan is set for the Patient, then "No Insurance Plan" will appear. Once a Plan has been applied, the Deductible will appear in blue text.
If multiple Insurance Companies are used by the patient, this number will only reflect the Deductible from the Primary Insurance (or the Insurance Company listed on the top of the Patient's Insurance tab.)
This will only apply to the selected Patient. If there are multiple Patients on the Account, another Patient will need to be selected in order to see their Deductible.