Overview
Dazos IQ uses three distinct patient-facing financial fields that are often confused with one another: Patient Responsibility, Patient Balance, and Balance Due – Patient. Understanding how each field is defined and calculated is essential for accurately interpreting billing data in IQ.
This article clarifies each field's definition, its formula, and how they relate to one another — including how to use the Patient Responsibility column to exclude balance bill amounts from your reporting.
Field Definitions and Formulas
Field | Definition | Formula |
Patient Responsibility | The portion of the claim assigned to the patient as their expected cost-sharing. This field does not subtract patient payments. | Deductible + Copay + Coinsurance |
Patient Balance | The amount the patient still owes after any payments they have already made. | Patient Responsibility − Patient Payments |
Balance Due – Patient | The outstanding patient balance after patient payments are applied. This field reflects the net amount the patient owes based on all data ingested from the billing platform. | Reflects outstanding balance after patient payments; driven by billing export data |
Key Distinction: Patient Responsibility Does Not Subtract Payments
A common point of confusion is whether Patient Responsibility already accounts for payments the patient has made. It does not. Here is the correct way to think about the relationship between these fields:
Patient Responsibility = Deductible + Copay + Coinsurance (gross patient cost-sharing, before any payments)
Patient Payments = Total cash received from the patient (tracked separately)
Patient Balance = Patient Responsibility − Patient Payments (what remains after payments are applied)
Patient Responsibility is the starting point. Patient Balance is the result after payments are subtracted. These are two separate fields and should never be conflated.
How to Exclude Balance Bill Amounts
If you want to report on patient cost-sharing that excludes balance bill amounts, use the Patient Responsibility column in IQ. By design, Patient Responsibility only includes:
Deductible
Copay
Coinsurance
Balance bill amounts are not included in the Patient Responsibility field. This makes it the correct column to reference when you need to isolate standard patient cost-sharing and exclude any balance bill from your reporting.
Balance Due – Patient, by contrast, reflects the broader outstanding balance as driven by the billing export and may include amounts beyond the standard cost-sharing components depending on how claims are recorded in your billing platform.
How the Billing Platform Affects IQ Data
The values that flow into IQ are determined by how your billing team records and categorizes transactions in their billing platform (for example, CollaborateMD). IQ ingests the raw billing export — including charges, claims, payments, and adjustments — and maps those values to the corresponding fields in IQ.
Because of this:
If balance bill amounts are being recorded in a way that affects Balance Due – Patient, the adjustment needs to happen at the billing platform level before the export is sent to IQ.
The Patient Responsibility column in IQ is specifically structured to capture only deductible, coinsurance, and copay — making it the reliable field for excluding balance bill from reports.
Troubleshooting: Numbers That Do Not Add Up
If you see values where Patient Balance does not equal Patient Responsibility minus Patient Payments, this may indicate a data mapping or recording issue originating in the billing platform. As a first step:
Compare the claim-level values in your billing system (deductible, coinsurance, copay, and patient payments) against what is showing in IQ.
Check whether the billing export mapping is aligning correctly with the expected field calculations.
If the discrepancy persists and cannot be explained by the billing data, submit a support ticket with the specific values you are seeing so the Dazos team can investigate.
Frequently Asked Questions
Q: Does Patient Responsibility subtract patient payments?
No. Patient Responsibility = Deductible + Copay + Coinsurance only. It does not subtract patient payments. Patient Balance is the field that subtracts payments.
Q: Which field should I use to exclude balance bill from my reporting?
Use the Patient Responsibility column. It is designed to include only deductible, coinsurance, and copay — balance bill is not included in this field.
Q: Can IQ be configured to exclude balance bill from Balance Due – Patient?
IQ does not provide a filter or exclusion setting for balance bill within the Balance Due – Patient field directly. How balance bill flows into IQ depends on how your billing team categorizes it in the source billing platform (such as CollaborateMD). For reporting that excludes balance bill, reference the Patient Responsibility column instead.
Q: What if my Patient Balance does not equal Patient Responsibility minus Patient Payments?
This suggests something may be off in the billing export data or field mapping. Cross-reference the claim-level values in your billing system and, if needed, submit a support ticket for further investigation.
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