Medical Billing process - Payment posting

How to post the payment - payment posting process


Yes, We will continue from last posting.

Claim

Claim # is the ticket number followed by 1, 2 or 3 for primary, secondary and tertiary insurance companies respectively.

•Claim
•Line Item
•Patient Payment

•CLAIM


Select this option if you are going to post the check by claim irrespective of the number of line items in the claim. Once we check this option, the details with reference to the claim are displayed in the claim status box. The following details are displayed: Patient Name, Insurance, Claim Status, Patient Type, First ID, Second ID, Par/Non-Par and the details of amount posted for a particular check.

In addition to the claim status box, the following box appears on the screen

Post By Claim
The following field need to be entered as per EOB

Claim Bal: This will show the total balance in the claim (For e.g. if there are three line items in the claim and the total billed amount is $150, then $150 will be displayed in the Claim Bal box).
Paid Amount: Here you will have to post the actual paid amount as given in the EOB.
Co-Ins: Here you will have to post the actual amount of Co-Ins or Co-pay as given in the EOB.
Deducible: Here you will have to post the deductible amount as given in the EOB.
EOB AllowedAmount: EOB Allowed Amount is generated automatically. (EOB Allowed Amount = Paid Amount + Co-Ins + Deductible). The System allowed amount will popup once you are in this field.
Write off: Write off is the difference between billed amount and system allowed amount.
We generally post the secondary payments by claim when we have earlier flipped the primary claim.


• LINE ITEM

Select this option if you are going to post the check by line item.Select this option if you are going to post the check by line item. Similar to the claims option, once you check this option, the claim status box will appear with the same details as given above.

Line Bal: This will show the total balance for the line item that is displayed.
Paid Amount: Here you will have to post the actual paid amount as given in the EOB for each line item.
Co-Ins: Here you will have to post the actual amount of Co-Ins for the line item as given in the EOB.
Deductible: Here you will have to post the Deductible amount for the line item as given in the EOB.
EOB Allowed Amount: This is generated automatically. (EOB Allowed Amount = Paid Amount + Co-Ins + Deductible) for each line item. The System allowed Amount will popup once you are in this field.
Write off: Write off is the difference between the Billed Amount and the System Allowed Amount.
Unposted:

The following category of payments are kept unposted:
• If a patient for or from whom a payment is received is not traceable in the system.
• If the payments are received for an existing patient in the system but for a DOS not billed by us.
• If a payment has been received for a claim which requires AR verification.
• If only the check is received but EOB not received.


For payments kept in unposted for reasons (3&4) once the necessary information has been obtained, the unposted entry has to be retrieved from the system and posted. ..



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