Step 7 - Payment Posting

Training Video

After completing the Claim Entry section, the next step in the patient visit process is Payment Posting.  This tab is where you will post all insurance payments (EOB) contained in the workbook.
 
  SEE THE “REMINDERS” and “SAMPLE OF INSURANCE PAYMENT FORMS” IN THE WORKBOOK!
  Following are the page numbers for each Payment Posting section:


 Rocky Shore pg 233   West Point pg 381
 Crown Valley pg 497 Prime Smile Dentistry pg 1117
 Rocky Shore A pg 151  West Point A pg 335
 Crown Valley A pg 423 Prime Smile Dentistry A pg 543
 Rocky Shore B pg 209  West Point B pg 379 Crown Valley B pg 473 Prime Smile Dentistry B pg 613
 Rocky Shore C pg 277  Sunset Springs pg 661
 Maple Hills pg 819
 Hidden Cities pg 945

 
Select the Payment –F3 to enter each EOB statement.


Review the Tabs
 
It is important to understand the seven tabs and their functions; however, you only use three of the tabs.  Understanding what tabs to use when posting the payments will minimize your scoring errors.    

 1.     Line Item Posting: If you forgot to enter the patient co-payment at the time of the claim entry, you can post it here. 

 2.     Account Posting: Not applicable.

 3.     EOB Posting: Enter all EOBs here.  It will calculate what you have applied and what remains, based on the total check   
        amount.  Also, you can retrieve anytime an EOB and edit the financial information.   

 4.     EOB Auto-Apply: Not applicable.

 5.     Adjustment: Not applicable.

 6.     Transaction Maintenance: The opportunity to delete any charge, payment, or adjustment.

            7.     Credit Management: Not applicable. 


Enter in Patient Co-Payment (in the 1 Line Item Posting Tab)

 
1 Line Item Posting: If you forgot to enter the patient co-pay at the time of the charge entry, you can enter it here.  Complete the screen in this six-step sequence:

1.     Click the Add button and search for your patient.    

 
             2.     Select Type of Transaction “D- Patient Co-pay.”

 3.     Click the Enter Data button on the office visit charge; the Enter Patient Co-Payment screen displays.

 4.     Enter Payment Amount, Payment Type, and Check #.

 5.     Click the Save button on this payment screen.

 6.     Click the Save button on the main screen.

 

 
Enter EOBs (in the 3 EOB Posting Tab)

 
3 EOB Posting tab: Enter all EOBs here.  To begin, click the Add button.  These five fields need to be completed:

        1.   Check From: Enter payer name.
        2.   Check Date: Also called Payment Date.  Enter date.
        3.   Check Number: Listed on EOB.  Enter number here.
        4.   Check Amount: Enter the total amount of the check.
        5.   Now, click the Add Payments for Claim button.  A search screen will display.  Enter the patient’s last name, as given on
                the EOB, and click the Search button.

 

 

The Claim Payment screen will display for you to enter in the insurance payment amounts.

Claim Payment Screen

Understand the columns, and in order to begin entering in the amounts from the insurance statement, place your cursor in the Allowed field.  Press Tab on the keyboard to continue to the next field.
 

 1.   Date: The date of service you entered from the claim form during claim entry.

 2.   Proc: Procedure; the charge code you entered from the claim form during claim entry.

 3.   Amount: The amount of the procedure/charge you entered from the claim form during claim entry.

 4.   Balance: The balance will adjust automatically based on any payments/adjustments entered in this screen and from the claim           entry screen.

 5.   Allowed: Place your cursor on the top line in the Allowed field, and enter the allowed amount given on the EOB.  If the Allowed           on the EOB is 0.00 (zero), you must manually calculate and enter the adjustment as the system does NOT calculate zero                   dollars allowed.  The formula for Allowed is: Billed minus Adjusted = Allowed.

 6.   Payment: Locate the Payment column and place the cursor in the top line field and enter the paid amount. 

       7.  Adjust: This field auto-calculates the Balance minus Allowed column; however, if additional adjustments are made, you                            can override this auto-filled amount.

 8.   Unpaid: This field auto-calculates the Allowed minus Paid column.  This bucket should combine the totals of both the 
       co-insurance/copayment and deductible, as stated on the EOB.  This field is the patient responsibility and is calculated into the
       account balance.
9.    Deduct: This field is informational only and does not count toward the patient’s debit.  The deductible is calculated with the
       Unpaid field.  Enter the deductible amount if given on the EOB.   

10.  Details: Not applicable.

11.  Billing Status: This defaults to the proper status; however, you can manually select a status of the charge.  If there is a
       balance in the Unpaid or Balance column:

a.     If the patient has a secondary insurance, the billing status should be “Send to ‘Name of 2nd Insurance.’”   

b.     If the patient does not have a secondary insurance, the billing status should be “Balance Due Patient,” as they owe the             deductible and/or coinsurance. 

12.  Remove: Check this box and immediately the Totals adjust as if you changed the fields to all zeros or removed this line. 

 

The following Claim Payment screens are for institutional and dental entries.  The only additional column is the 3rd column that provides additional information to help distinguish between the line items of the claim.

 


When you are satisfied with your entries, click the Apply button at the bottom, right of screen, to save this posting. You will return to the previous screen.  

To continue to add another patient to this EOB, click the Add Payments for Claim button.


Other Functions


Retrieve Any EOB to View or Edit:

Click the Find button.

 

Next, the Search Checks screen displays.  Immediately click Search (intentionally leaving the screen blank to bring up all EOBs posted).

The Find Insurance Payment screen displays.  Click on the desired EOB.

The EOB will display for you to view.

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Edit Payment Postings:

View the totals here.  The benefit of posting all EOB entries under the 3 EOB Posting tab is that at anytime, you can edit the allowed, payment, and adjustment. By clicking on the patient name, you will be taken to the Claim Payment screen (see previous screen).  Make any corrections, and click the Apply button again. 




Auto-Calculates Your Posting:

Make sure your Applied total is the same amount as the EOBs Check Amount, and the Remaining total is $0.00.

 

Add Multiple Patients from the EOB:

If the EOB contains entries for multiple patients, simply click the Add Payments for Claim button for each additional patient.

 
 
Delete an EOB Entry:

If a patient EOB entry is incorrect, you can select Remove on the right side of the patient’s claim to remove all payment, adjustment, and allowed data.  To edit the information, click the patient name to bring up the Claim Payment screen to re-enter the data correctly.

Save the EOB:

When all the money from this check has been applied (Remaining = $0.00), click the Save button. 

 

Delete/Review Any Transaction (in the 6 Transaction Maintenance Tab)

Transaction Maintenance provides the opportunity to delete any charge, payment, or adjustment.  There are six steps to follow (see the buttons and screen below):

1. Click the Find or Find for Active Patient button.
2. Check All Transaction Types
3.  At the top right of the screen, click the Retrieve Data button.
4.  Transaction(s) displays as shown below for this patient.  Click the Expand All button to quickly view all transactions.

5.  All transaction types display.  The only thing you can do here is delete a charge, payment, or adjustment.  Do so cautiously by selecting the appropriate line(s) in the Delete column.

6.  Click the Save button to permanently delete the items checked or click the Close button to not save the deletions.