Click the “Billing” button.
Go to the left and click “Insurance Payment”. This will take you to the insurance payment detail screen.
Select the payer/carrier.
Post Date: Displays the day the payment will appear on the Deposit Report.
Provider: Take care when selecting a provider on the insurance payments for the following reasons:
First, if the practice is an individual doctor, there is no reason to select a provider.
Second, if the practice is a multiple-provider practice, most of the time the insurance payments will have multiple providers. So, you can leave Provider blank.
Method: Check or Electronic
Reference Number: Check or EFT Number.
Check Date: The date the check was issued.
Total Amount: The amount of the full check. When you apply the payment, you will break it into individual patients and claims.
Note Box: Allows you to enter notes about the payment.
Click “Save”.
Applying Insurance Payment
From the Payment Detail screen, click “Apply”. This will take you to the posting screen.
Type the patient’s last name or claim number into the Claim Number box. A list of claims will appear.
Highlight the claim you want to post (Patient Name, Claim Number, Date of Service). You will see the date of service and procedure that relate to the claim.
Go to the first procedure code and you will see the charge amount.
Type the allowed amount (equals the amount insurance paid and the patient’s responsibility).
Tab over and type the paid amount (what the insurance paid).
Tab to the adjustment column (equals the difference between the charged and allowed amount).
If the office is a participating member, this is automatically filled out.
If the office is non-participating, manually fill this out because the office does not need to abide by a fee schedule and can technically bill the patient the remaining balance. This means that the allowed amount should be the same as the charged amount.
Second Adjustment column: Use this to record any other adjustment (like writing off the patient responsibility).
Copay, DED, Coinsurance Column: Indicates the bill is the patient’s responsibility.
If the office is a participating member this is automatically filled out. This is the difference between the allowed amount and what the insurance pays.
If the office is non-participating, the office will need to manually fill this in.
Patient Payment column: This will be blank if the office has not applied the patient payment.
The insurance balance should also be zeros if the payment was applied correctly.
The Patient Balance column will display the patient’s responsibility.
Repeat the steps above for each procedure code on the claim and then click “Save”.
A pop-up box will appear stating that the balance was transferred to the patient and the claim is marked “complete”.
Applying Patient Payment While Applying Insurance Payment
Above the Claim Number box you’ll find the Patient Payment tab.
Click the tab and it will take you to the Patient Posting screen.
Click the dropdown arrow and a list of unapplied payments will appear.
Highlight the payment you want to apply. The date of service and procedure codes will appear.
Find the date of service and apply it either in the copay, DED, or coinsurance.
Click “Save”
Continue Applying the Insurance Payment
Click the “Insurance Payment” tab at the top left of the page. This will take you to the insurance posting screen. Go to the Claim Number box to search for the next claim you want to post.
Continue until all the payments are applied. (On the top right of the posting screen the application will inform you how much funds remain unapplied)
Insurance Split Up Detail Tab
This report indicates for whom and what you have posted on this insurance check.
The report is printable.
Use this report if a check is not balancing.