Sometimes carriers include interest with a Insurance Claim Payments. To enter the interest amount, you have three options.
Option 1: If this is a PPO plan and the write-off amount is greater than the interest payment, follow these steps. This method keeps your account accurate, but does not track interest amounts.
- For a specific patient, open the unreceived claim, then double -click on a procedure to open the Claim Procedures (claimprocs).
- Add the interest payment amount (what the insurance paid extra) to the Insurance Paid amount.
- Reduce the write-off amount by the interest payment amount.
- Click OK to save.
- Finalize the insurance payment.
Option 2: This method adds a supplemental payment to the claim and an adjustment to the patient account.
- For a specific patient, open the received claim. A finalized insurance payment should already be created for the initial payment amount.
- Highlight a procedure, then click Supplemental.
- Enter the amount of the interest payment, enter a note that it is an interest payment, then click OK.
- Click This Claim Only to enter the payment information, then click OK. We recommend entering a note that it is an interest payment.
- If Payment and Total Payment amounts match, click OK.
Note: At least two finalized payments will show in the Insurance Payments area of the Edit Claim window: one for the insurance payment amount, one for the interest amount.
- The patient balance will now reflect the interest amount. Add an adjustment to subtract the interest amount from the patient's account. We recommend you create an Interest adjustment type in Definitions: Adj Types.
To track interest amounts, run an Daily Adjustments Report.
Option 3: This method requires more steps, but allows you to track interest amounts per insurance company.
- Create a fake patient named for the insurance company. e.g. Interest.
- In the fake patient's Family Module, add the patient's insurance plan.
- Create a N code procedure called interest or service charge.
- Add the N code procedure to the fake patient's Chart Module and verify the correct provider is assigned (who should receive the charge or payment). Set the procedure complete.
- Go to the Account Module. The N code procedure will have a zero fee. Highlight the procedure, then click New Claim. Change the status to Sent, then click OK to create the claim.
- Receiving Claims: Reopen the claim and enter a By Procedure Insurance Claim Payments. Indicate the amount charged or credited to you by insurance. For charges (e.g. service charges), enter a negative number.
- Enter the payment: Click Batch or This Claim Only, then click OK. All patients on that check should be in the Attached to this Payment list, and the Payment Detail Amount should match the Total Payments amount. Click OK.
The fake patient should have an account credit or balance. Do not make an adjustment; leave the balance as is.
To keep track of insurance interest, make an adjustment at the end of the year (Adjustments). Then, create a new fake patient for any new insurance to keep the information separate.