Last updated 10/24/2007

The Payments Screen
This screen is where everything payment-related to an invoice can be done. The charges cannot be altered on this screen. Let's go "from top to bottom" and discuss in detail what each section does and how they impact posting your payments! The topics discussed are:

• The Top section with patient, Insurance, Provider and Diagnosis information
• The Second section with Charges and Reimbursement information
• Adding and Editing Reimbursements is discussed in detail in another chapter
• The Third section where the payments are posted has its own chapter
• The Fourth section, Claims Processing, where invoices Claims and patient Statements can be resubmitted and monitored are discussed in another section
  

When we train people about this screen, be like to describe each invoice as a new story, with a beginning, and few chapters in the middle and finally the end. It is important that when you post payments that you review each section of the screen as if you were reading a new story.

Patient, Provider, Diagnosis Overview
The top section has the patient's name and current invoice number. Always make sure you have the correct patient and invoice before you post a payment. Other parts show you the following:

• Which insurance the claim was Billed to and which insurances are the 1⁰ , 2⁰ or 3⁰. You can quickly review any listed insurance by clicking its associated icon. To return to the same invoice from the Insurances module just click the Go button.
• Clicking in the Refer Doc, Off Doc*, Group* and Facility fields allows you to change any of these entries (*These fields require the Administrator's password to change once charges have been added to an invoice). Changing the Off Doc, Group or Facility values requires that you use a dialog like the one below. This insures that each lineitem is properly associated with the correct data.

• To change Dxs 1 to 4 for the claim just click in the field and make your change. Keep in mind that the safeguards used on Charge Entry to insure proper diagnosis selection are NOT used on this screen.
  

Charges Review Section on top
This second section shows all the Charges on this invoice. Make sure all charges were considered properly and that the insurance did not "down code" your charges!

• Before you post payments, make sure that the Approved amount has been entered and equals the amount that was paid for each charge. If the field is blank you can click in the field and enter the approved amount. However, what you enter here will NOT change what is stored in the Reimbursements database. To read more about Reimbursements click here.
• This section also has the Linepost section which shows you exactly what you were paid for each charge!
• To see more information on a particular procedure, click on its icon and its data record in the Procedures module comes forward.
  

• To change the modifiers just click into a modifier field and make a selection from the pop-up list.
• To toggle an insurance charge to the patient side click on the P column check box for that line. You would do this if you only want to temporarily remove the charge from the insurance side of a claim so that it does not get resubmitted the next time you send the claim.

The fields Appr$, Actual$ and Copay$ show how much the Primary Carrier for this claim approves for that line charge.  If there is an associated multiplier (like Medicare’s 80% or .8) the calculated Actual$ amount is shown. Copay$ has the expected copayment, whether coming from an insurance or the patient.  The calculated totals tell you how much to expect for this claim. There values are stored in the Reimbursements database.

Surgeons note: If you want to add a no charge post-operative visit to the invoice click the POV button at the top. This is primarily used for surgical practices that want a record of when the patient was seen for a post-operative visit after surgery.