Before posting, add an Insurance Receipt for the full amount of the check.
Using the Receipt that was created for this payment, select the Post button.
Enter the Encounter number preceded by an e (e1234) and tab or lookup the Patient using the Lookup icon on the Patient field and select the Encounter.
The Post as Insurance field will default to the insurance chosen on the receipt.
If a Secondary claim paid as a Primary, use the Post As Responsibility field to choose Primary. All fields for a Primary payment will display.
Check the Crossed to Secondary checkbox on the Primary Payment screen when they are automatically crossed to the Secondary Payer. (This is usually Medicare or RR Medicare.)
The system automatically defaults to the Payment button. If this is a Takeback, choose the Takeback button.
The Post Claim Level button is used for auto accidents and other claim level adjudications. Most clients will not use this button.
Enter the Allowed amount. (The CO45 is auto calculated when the allowed amount is entered.
If there is not an allowed amount on the EOB, leave the field blank, and it will auto-populate after entering the paid and CO45 amounts.
Enter the Paid amount.
The CO45 field auto-populates when the Allowed Amount is entered. If the CO45 field did not populate, enter the adjustment amount.
Copay (PR3): Enter the Copay amount on the EOB
Deductible (PR1): Enter the amount that is being applied to the patient's deductible.
Coinsurance (PR2): Enter the coinsurance amount from the EOB
Other Codes: Enter other adjustment codes in the Other Code field, such as sequestration, CO253.
Other Amount: Enter the dollar amount for the Other Code that you entered above
To add additional adjustments, select the plus symbol (+) beside Other Code.
Note: For interoffice communication. There is an option on the Patient Ledger to display this note.
All Distributed displays in this field if the lines are posted correctly.
Undistributed and the amount displays if the lines are incomplete or incorrect. All money must be distributed before this page can be Saved.
Balance To: If the claim was paid, it automatically defaults to the next responsible party. Using the dropdown, it can be changed to leave the balance with the current payer or move to another payer or to the patient.
To Worklist: Send the encounter to a custom worklist for review. (The Custom Worklist must be set up first.)
Save [F2].
Example of Undistributed
The Post Insurance Payment(s) screen will display to post the next payment on the EOB.
As you post the Encounter Payments on the EOB against this receipt, the Escrow on this Receipt will decrease. When the Escrow amount reaches 0.00, all payments have been posted. If there is any money left in Escrow, the Receipt has not been completely posted.
After completely posting the Receipt, you can start a new Receipt using the Navigation Search box shortcut "nr" or select Payments on the Left Side Menu and then select the Post Payment button.
For example, a PR45 was posted in error instead of a CO45.
Find the original Receipt.
Select the Receipt number.
Select the Post (Expert Mode) button.
If you were on the Patient Dashboard, the Patient ID will auto-populate. If it did not, use the Lookup icon to search for the Patient.
Select the Encounter where the change is to be made.
Transaction Code and Amount
In the Transaction Code field, enter PR45.
Amount: Enter the negative of the original amount and Tab.
In the Transaction Code field, enter CO45.
Amount: Enter the positive of the original amount and Tab.
Select Save [F2].