Applying an insurance payment as an EOB includes associating adjustment(s) and reason code(s).
Select Payment > Post.
Fill in the option for Insurance Payment.
Click on the icon next to Payment By to search for the insurance payer you received the payment from. Or click on the icon to “Find by Claim”
Enter the check information (e.g., Payment Amount, Received/Check Date, Check/EFT#, Other Ref#, and Source), and then click the Apply as EOB button.
If In-application Credit Card Processing feature is enabled, complete one of the following options:
Option 1: Place your cursor in the “Card #” box and swipe the payer’s credit card reader.
Option 2: Manually enter the credit card number followed by the expiration date.
You will not see a confirmation if the transaction is successful. The system will alert you if the transaction fails or you attempt to make a credit card payment without entering the complete card information.
In the Payment window, choose any of the options below to Add payments for:
Claim: Search for any other claim you would like to associate with this EOB.
Account Debit: This will search for debits.
Claims at <PAYER NAME>: This will search for claims that are currently at the payer the EOB is associated with.
If the Payer is not associated to any of the claim(s) added to the check, you will receive a warning notification requesting asking to verify this is the correct claim and to select the TCN.
Click on the Payment Line to open the detailed payment information for the selected claim.
Use the Action drop-down menu to select an action for this payment.
Processed: Marks the payment as processed.
Processed and Forwarded: Marks the payment as processed. Also notes that the remaining balance should be forwarded to a Secondary or Tertiary Payer.
Denied: Marks the payment as denied.
Refund / Reversal: Marks the payment as a refund, typically used if the payer requests any payments back.
Use the TCN drop-down menu to select the submission to a payer.
This controls which payer any Remark, Adjustment Reason or Unpaid Reason codes are from. If no TCN is found, you will be unable to add remittance information such as Remark, Adjustment, and Unpaid Reason codes.
Use the Claim Status drop-down menu to set the status for any claims associated with this payment.
Enter the Allowed, Paid, Adjusted amounts based on your EOB.
Enter any Remark, Adjustment Reason, and Unpaid Reason codes based on your EOB.
Reference our Remittance Codes Actions Help Article for steps on how to automate process based on the code used.
Click the button to access additional actions for this claim.
- Print Claim After Saving: With this action enabled, the system will print a copy of this claim after to save the payment.
Create Task: Quickly create a task for this claim and payment.
Set All Charges to Paid: Quickly set all charges on this claim to the Paid status.
- Change Payment Source: Change the Payment By payer for this claim within the EOB payment.
Click Done, then click the Save Payment button.