Balance requiring action (Enter Payment Amounts)
{{::data.ClientName}} |
Patient | Responsible Party | Account # | Account # | Claim Number | Date of Service | Balance | Discount Amount | Payment Amount | discount information |
---|---|---|---|---|---|---|---|---|---|
|
Total: | {{::payment.TotalBalanceAmount|currency}} | {{payment.TotalDiscount|currency}} | {{payment.TotalPlanAmount|currency}} |