If the insurance company only pays you partially, or if they pay the insured member directly, you can record the patient's payment to you in the CHR. At times the insurer may pay you by cheque. You can then record the payment in the CHR manually.
You can record payment at any stage after you submit a claim.
Steps
1. From the patient chart, click Start/Open > Insured Billing.
2. Next to the third-party insurance claim you want to record payment for, in the Action column, click the Add payment dollar sign icon.
📌Note: For eClaims you can see how much money the insurer paid you for the entire claim and for each claim's billing items from the Insured Payment section under the Paid amount column.
3. The Payment window appears.
Refer to the below table for detailed descriptions of the available fields:
Item | Description |
Total Amount | The claim item total. |
Processed | The amount you are expecting to collect. The total of Discount, Paid, and Wrote Off amounts minus any Refunded amount. |
Discount | The total discount on the invoice. Click + to add a discount. For more information, refer to Writing off, discounting, or refunding third-party payments. |
Paid | The total amount paid. To make a payment, click +. Refer to the step below for more details. |
Refunded | The total amount refunded. Click + and record the transaction details. For more information, refer to Writing off, discounting, or refunding third-party payments. |
Wrote off | The total amount written off. Click + and record the transaction details. For more information, refer to Writing off, discounting, or refunding third-party payments. |
Unpaid | The total amount outstanding on the billing item. Calculated as Total Amount minus Processed. |
History | Shows all transaction items, including a time stamp. This also appears in the PDF invoice. |
4. To record a payment, next to Paid, click +. The Add Payment window appears.
5. Complete the payment details.
Field | Description |
Method | Select a payment method from the list (e.g. Cash, Debit Card). |
Amount | Defaults to the full amount of the bill. If the patient is not paying in full, change the amount. |
Processed Date | Defaults to today's date. To change the date the payment was made, click the calendar icon. |
Note | Add an internal note associated with the payment. Shows in the History section of the payment window. |
6. Click Submit in the Add Payment window. The Paid, Processed and Unpaid amounts are updated.
7. Click Close in the Payment window, and the payment is recorded.
📌Note: For eClaims, when you apply payment at the claim level, the system updates the billing items in the order they were added to the bill. For example, a claim has two billing items, $30 (added first) and $20. The insurer only paid $40. The first billing item has a paid amount of $30 while the other one has a partially paid amount of $10.
8. In order to filter the billing dashboard accurately for any outstanding claims, mark the claim as completed:
a. Open the claim and verify that all the payments have been applied correctly and no further action/changes are required for the claim.
b. In the Edit Insured Payment window, click the Status field and select Mark as Completed.
c. Click Save.
⚠️Important: When a claim or billing item is marked as Completed, you cannot make any changes to it, except to record a payment.
Updated June 27, 2024