Deductible Management Process

The Deductible Management feature is an automated process that assists with holding a bill in an incomplete status until the system automatically verifies that the claim is ready for billing based on the configurable settings in AIM Intelligence Setup. It is advised to review AIM Intelligence Setup and configure appropriate settings for the Deductible Management process before beginning use of this feature.

Adding Bills to the Deductible Management Cycle

When conducting an eligibility check, if the Deductible Management feature is enabled in AIM Intelligence Setup, a new button will display in the Eligibility Results section titled "Manage Deductible". Clicking this button will open a new pop up titled "Deductible Selection". 

The Deductible Selection screen contains the data from the Deductible section of the eligibility results. As discerning the correct deductible amount requires the keen insight of a trained biller, the system will prompt for a deductible amount to be selected within this screen. Once a selection is made, that deductible amount will be utilized in future eligibility checks in order to monitor the balance moving forward.

Following the selection of a deductible in the Deductible Selection screen, a few things happen:

The Deductible Balance will display in the Payer Eligibility screen to quickly show the balance on future eligibility checks. It will only display for the payer whose deductible is being managed.

An icon will appear on the top of the bill next to the patient name, indicating that the bill is actively on hold within the Deductible Management process. This icon appears to anyone viewing the bill and will disappear once the bill cycles out of the Deductible Management hold status.

Users will be able to see the Deductible Balance while a bill is actively on hold within the Deductible Management process. One of those locations is within the Edit or View Payers screen.

Another location is within the Accounts/Subscription module, under the Members Tab's Account Member Payers screen.

Users can also monitor the progress of both the manual and automated eligibility checks for all of the patients' bills within this screen. The most recent eligibility data will be available on the top row of the grid. This data shows for the last 2 years. 

Cycling-Out of the Deductible Management Hold Process

The Deductible Management feature is meant to be a hands-off, automated process. Once bills are entered-into the Deductible Management process, the settings in AIM Intelligence Setup allow for the bills to automatically be put back into a Waiting status (assuming all validations and required fields are completed) once the patients' Deductible Balance reaches a configurable amount, or a number of days have passed since the Date of Service of the bill in order to prevent running into complications from Timely Filing deadlines.

Bills that are actively within the Deductible Management hold will have eligibility checks automatically conducted on a routine basis.

Enter a number in the Check Deductible Automatically Every ___ Days field in order to set the frequency of the automated eligibility checks of bills held in the Deductible Management cycle.

Enter a number of days in the Release From Deductible Hold Automatically After ___ Days field in order to automatically return bills in the Deductible Management cycle to a waiting status (assuming all validations and required fields are completed) based on the number of days from the date of service of the bill, regardless of the current balance of the selected deductible.

Enter a monetary amount in the Release From Deductible Hole Automatically When Deductible Balance Is Less Than or Equal To to automatically return bills in the Deductible Management cycle to a waiting status (assuming all validations and required fields are completed).