Introduction to Insurance Payment Posting

Introduction to Insurance Payment Posting

Introduction to Insurance Payment Posting

Create/Load Payment Detail is manually entered using information from the Remittance/EOB.

 

Patient Details Displays patient information from the General Demographics section and Patient/Family Balances from the Patient Ledger

Claims Lists Outstanding/Unpaid insurance claims for the Patient, the status of the Claim and details pertaining to the claim. To include paid claims in the list, place a check mark in the box next to Show All Claims

Claim Details Populated with information pertaining to the claim. Payment information is manually added with information from the remit/EOB

Charges Breaks down the individual charges/services that are included in the selected visit/claim. Double Click on a line item to view Charge Details

Select Claim/Visit for Payment

Select Claim/Visit for Payment

Outstanding claims are listed in the Claims section of the Posting window. If a claim is highlighted, the lower section of the window displays each line item/charge that makes up the selected claim. Details in both the Claims and Charges sections can be sorted by Clicking on the column headers.

1. Click inside the Claim grid to select a claim for payment.

 

2. Details of the selected claim will display in the Charges section of the window.

Enter Claim Details using Remit/EOB

Enter Claim Details using Remit/EOB

The Claim Details section displays various details entered when charging the selected claim, including miscellaneous accident/illness info. This information cannot be edited.  Payment information is entered using details from the Insurance Remittance.

3.  Type Total Payment amount for the selected claim. An alert will show if an amount more than the remaining amount of the check is entered

4. Type Claim Control number from Remit for informational/tracking purposes

5. Enter total amount that is the responsibility of the insured/patient as shown on Remit

Apply Payment to Charges

Apply Payment to Charges

The payment is ready to be applied to the charges. Note that the Remaining Balance amount is the same as the Payment Amount and will decrease as payments are applied to the line items. When the last payment is applied to the final charge, the Remaining Balance should be zero.

6. Match the remit payment to the correct charge by verifying Begin and End dates, Procedure code and Amount Billed.

7. Click on the line of the charge inside the Allowed Column and enter the amount shown on the EOB as the Allowed amount.

8. Tab to the next column and enter any amount that was applied to the deductible, CoInsurance, etc and then finally enter the payment amount that was paid for the line item charge and repeat until the remaining Balance is zero, all charges for the selected claim have the correct information applied and the Save Claim button is activated

9. Click Save Claim.  A pop up message will verify payment was saved. Click OK.

10. If Cancel is clicked, a confirmation box asks if you want to close the Patient and lose changes. If Yes, the patient window will cancel all data entered for the active patient and close the account If an amount is remaining on the remit, Select Patient dialog displays to choose a new patient.

Note: A payment can be edited after Save Claim, but cannot be edited if the remit has been Posted to ledger.

Post Insurance Payment to Patient Ledger

Post Insurance Payment to Patient Ledger

If the Insurance EOB is for a single patient payment, and the Remaining Balance in the upper section/Remit details is zero, the Remit/EOB will need to be posted to the patient ledger and closed. If the Remit/EOB is for multiple patients/payments, you will be prompted to select another patient and will repeat the previous steps until the entire check is applied.

1. Print Payment (optional). Generata a report to verify all payments and how they were applied for the active remit/check. Make any corrections/edits prior to Posting to remit.

2. Click the Post Payment button to Apply payment(s) to Patient Ledger. Payment will not be reflected in Patient ledger until it is Posted

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