Every invoice in Suno splits the total amount between two parties: the patient and the insurer (or managed care plan). This is called the responsibility split, and it determines how much each party owes for each line item. If the split is incorrect, charges may be assigned to the wrong party—for example, the patient may be billed for amounts that should go to insurance, or vice versa.
This article walks you through how to spot an incorrect responsibility split and how to fix it.
How Responsibility Splits Work
When you create an invoice, Suno automatically sets the default responsibility based on the Payment Source you select:
Payment Source | Default Patient Responsibility | Default Insurance Responsibility |
Private Pay | 100% of line item total | $0.00 |
Insurance | $0.00 | 100% of line item total |
Managed Care | $0.00 | 100% of line item total |
These defaults are applied to every line item on the invoice. You can then manually adjust the split on each line item as needed (for example, to reflect a copay or coinsurance amount).
Key concept: The patient responsibility and insurance responsibility on a line item must always add up to the line item total. If you increase one, the other decreases automatically.
How to Identify an Incorrect Responsibility Split
Symptom 1: Patient Owes More Than Expected
If a patient’s balance is higher than expected—for example, the full invoice amount appears under Patient Responsibility even though it should be billed to insurance—the responsibility split is likely set to Private Pay.
Where to check:
Open the patient’s Billing tab and select the relevant invoice.
In the Invoice Details panel on the right, review:
Patient Responsibility – the amount the patient owes
Insurance Responsibility – the amount the insurer owes
Symptom 2: Insurance Owes More Than Expected
If the Insurance Responsibility amount is higher than expected, but the patient should owe a copay, deductible, or coinsurance, the responsibility split on the line items likely needs to be adjusted.
How to Fix the Responsibility Split
Step 1: Verify or Change the Payment Source
Navigate to the patient's profile → Billing tab.
Open the invoice you need to correct by clicking the
Pencilicon.At the top of the invoice form, locate the Payment Source dropdown.
Confirm it is set to the correct value:
Private Pay - if the patient is paying out of pocket.
Insurance - if insurance should be billed. You will also need to select the Primary Insurance Policy (and optionally a Secondary Insurance Policy).
Managed Care - if a managed care plan applies. You will also need to select the Managed Care Plan.
If you change the Payment Source, the responsibility split on all line items will update to the new default (100% to patient for Private Pay, 100% to insurer for Insurance/Managed Care).
Important: Changing the Payment Source resets the responsibility split to defaults. If you had custom splits on individual line items, you will need to re-enter them after changing the Payment Source.
Step 2: Adjust the Split on Individual Line Items
After setting the correct Payment Source, you can fine-tune the split on each line item. This is useful when the patient owes a copay, coinsurance, or deductible.
On the invoice edit page:
Locate the line items table on the invoice.
Each line item has two editable columns:
Patient Responsibility - the dollar amount the patient owes for this line item.
Insurance Responsibility (or Managed Care Responsibility) - the dollar amount the insurer/plan owes for this line item.
Click on either the Patient Responsibility or Insurance Responsibility value for a line item to edit it.
Enter the correct dollar amount. The other field will automatically update so that the two amounts equal the line item total.
Save the invoice.
Note: If the Payment Source is set to Private Pay, the responsibility fields are read-only and cannot be edited. The full amount is always assigned to the patient. To enable editing, change the Payment Source to Insurance or Managed Care.
Step 3: Assign a Responsible Insurer (If Applicable)
If the practice has multiple insurance policies on file for the patient (primary and secondary), you can specify which insurer is responsible for each line item's insurance portion:
On the line items table, look for the Responsible Insurer column.
Click on a line item's responsible insurer cell to open the insurer assignment popover.
You can assign the insurance responsibility amount between the primary and secondary insurers.
The amounts across all assigned insurers will automatically balance to equal the total insurance responsibility for that line item.
Adjusting Responsibility During Insurance Payment Posting
When posting an insurance payment (after receiving an ERA/EOB), you have additional options for managing the responsibility split:
Post Payment Per Line Item
Toggle the "Post Payment Per Line Item" switch to distribute the insurance payment, adjustments, and responsibility changes across individual line items rather than as a lump sum.
Transfer Remaining Balance to Patient Responsibility
Toggle the "Assign Remaining Amount to Patient Responsibility" switch to automatically move any outstanding insurance balance to patient responsibility after the payment is posted. This is commonly used when:
The insurer has paid their portion and the remainder (copay, coinsurance, deductible) should now be collected from the patient.
The insurer denied or partially paid a claim and the patient is responsible for the rest.
Note: When applying ERA claim remittances, this toggle is labeled "Transfer Outstanding Balance to Patient Responsibility." If the invoice has a secondary insurance policy, this toggle defaults to off (since the secondary insurer may still need to be billed).
Common Scenarios & Solutions
Scenario: Patient Should Owe a Copay, but Entire Amount Is on Insurance
Open the invoice (Payment Source should already be set to Insurance).
On the relevant line item(s), click the Patient Responsibility field.
Enter the copay amount (e.g., $25.00). The insurance responsibility will automatically decrease by the same amount.
Save.
Scenario: Insurance Denied a Claim - Transferring Balance to Patient
Open the Insurance Payment form for the invoice.
Record the denial (payment of $0.00 and any applicable adjustments).
Enable "Assign Remaining Amount to Patient Responsibility".
Submit. The remaining insurer balance will transfer to the patient's responsibility.
Still Need Help?
If the responsibility split looks correct but the balances still seem off, the issue may be related to payments, adjustments, or refunds applied to the invoice rather than the split itself. Review the Payments, Adjustments, and Refunds sections on the Invoice Details panel to see if those totals account for the discrepancy.
If you're still unable to resolve the issue, please contact Suno Support with the patient name and invoice number and we'll be happy to help.