Accounts Receivable

Overview

The accounts receivable endpoint reports on outstanding invoice balances for out-of-pocket and insurance charges. Using the information in these records, users may create aging reports which makes it easy for businesses to identify late-paying customers and to analyze their internal collection processes.

Where possible, NexHealth reads balance values directly from the EHR. Otherwise, NexHealth computes A/R balances from individual ledger transactions (ie: payments, charges and adjustments).

Use Cases

At this time, the two available types of A/R records are guarantor accounts receivable and insurance accounts receivable. Both return the total balance owed as well as the 30, 60, and 90 day aging balance of the particular account. In many offices, a majority of revenue is collected via insurance payments.

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Patient balance

Please note that a guarantor accounts receivable record in NexHealth may reflect the balance of ledger transactions of multiple patients. Individual patient balance is not directly available at this time via this or other endpoints.

Guarantor accounts receivable

A guarantor is the individual or entity financially responsible for a patient's medical expenses. The guarantor may be the patient themselves, a parent or legal guardian (for minors), a spouse, or another third party who agrees to cover the costs. In NexHealth, guarantors are stored as patient records and as such, have patient ids. If they are only guarantors and are not patient's of the practice, they will have a patient.non_patient value of true.

In addition to the guarantor's patient id, the guarantor accounts receivable response includes a total_balance which is the sum of guarantor_portion (the amount owed by the guarantor) and insurance_estimate (the amount owed by their insurance provider). For more information on insurance estimates, please see the landing page for the insurance claims endpoint.

Write off estimate value

The guarantor aging balance includes an estimated write off field. A write off is an amount the practice won’t collect from either insurance or the guarantor. Write off estimates are not supported for all integrations. Please see the Supported Health Record Systems notes at the bottom of this page for more information.

Calculating guarantors out of pocket aging balance

While it is not directly supported, it is possible to calculate a guarantor's out-of-pocket aging balance by subtracting the aging insurance balance and write off estimate from the guarantor's total aging balance.

Insurance accounts receivable

While every guarantor will only ever be associated with one guarantor A/R record, a guarantor may be associated with multiple insurance A/R records. Insurance A/R records include the guarantor and patient id. If the patient is their own guarantor, both fields will contain the same value.

Supported Health Record Systems