Finalize Insurance Payment
Finalizing a Claim Payment attaches received claims to payments. It is imperative that you attach all received claims to an insurance payment so that payments show in the Daily Payments Report, Production and Income Reports, and Deposits.
Follow the instructions below to finalize a single claim or small batch EOB from the Claim. If finalizing a large batch EOB payment, use the Batch Insurance Payment window instead. You can limit where users can finalize payments in Manage Module Preferences.
To finalize a small batch EOB payment, click Batch. The default payment amount will automatically calculate based on the combined total of all received claims not attached to a payment. If you have been receiving claims, but not finalizing them, the payment amount may be larger than the EOB amount. See Troubleshooting below
If there are any secondary claims, a new window will show listing the claims. See Secondary Insurance.
The insurance payment will list in the Account module. If you reopen any claim attached to the payment, the Insurance Payments area on the Edit Claim window will show the payment.
Delete: If you delete an insurance payment, received claims will remain unattached until a new payment is created. Payment splits are not affected.
When entering a batch insurance payment, the default amount is too big and doesn't match the EOB amount.
This occurs when claims have been received, but not finalized. All received claims not finalized are automatically included in the total amount calculation, and you will see the claims listed in the Attached to this Payment grid.
If you always receive the claim(s), then finalize, the amounts and claims will always be accurate and data entry will be reduced.
Insurance payments that haven't been finalized are indicated with a note:
A procedure has a write-off, yet we received zero payment. When finalizing the payment, we changed the payment date to match when we received it. Now the procedure with the write-off and zero payment incorrectly shows the date we entered the payment instead of the date we received it. There are two entries for the payment in the Patient Account since they have different dates.
You must manually open the procedure on the claim and change the payment date to the receive date. This will merge the two payment entries into one since they will have the same date.
What if I cannot receive all of the claims that make up my bulk check/payment and I need to leave for the day?
Do not finalize the payment until you finish receiving all the claims. This way all claim payments will have the same payment date.
I have a bulk payment but the carrier is taking back money from a previous claim. How do I enter the claim?
See Insurance Refunds.