Finalize an insurance payment after receiving claims for an EOB.

In the Edit Claim window, in the middle, is the Insurance Payments area.

See our Webinar: Claim Payments.

Batch: Click to finalize a bulk insurance payment attached to multiple claims. See Finalizing a Bulk Insurance Payment below for detailed steps.

This Claim Only: Click to finalize payment for a single claim. See Finalizing a Single Claim below for detailed steps.

Finalizing a Single Claim

To finalize insurance claim payment for a single claim, follow the steps below:

1. Receive Claim payment.
2. From the received claim, click This Claim Only.
3. Enter payment details into Edit Insurance Payment.
4. If processing a virtual credit card payment, click the button for the credit card processor and follow the prompts to process payment.
5. Click OK.
6. Optional: Scan EOB to attach it to the payment.
7. Click OK on the Insurance Payment (EOB) window to finish finalizing payment.

Finalizing a Bulk Insurance Payment

To finalize bulk insurance payment attached to multiple claims follow the steps below:

1. Receive claim payment for all claims on the EOB.
2. After receiving the last claim on the EOB, click Batch from the Claim.
3. Enter payment details into Edit Insurance Payment.
4. If processing a virtual credit card payment, click the button for the credit card processor and follow the prompts to process payment.
5. Click OK.
6. From the Insurance Payment (EOB) window, verify the claims in the Attached to this Payment grid match the claims on the EOB.
   • All claims that have not been attached to a payment appear here. Claims that are not part of the EOB currently being finalized should be detached. See Troubleshooting below for additional details.
   • The Amount and Total Payments should match if the correct claims are attached.
7. Verify Payment Details.
8. Optional: Scan the EOB to attach it to the payment.
9. Click OK to finish finalizing payment.

Alternatively, batch insurance payments can be finalized from the Manage Module using the Batch Insurance Payment feature. If Finalize claim payments in Batch Insurance window only is enabled in Preferences, users must finalize insurance payments from the Manage Module using the Batch Insurance Payment feature.

Troubleshooting

When trying to finalize a $0 payment I get a warning.

If the preference, Show claims received after days (blank to disable), is blank, users cannot finalize any $0 payments. Enter a number into this preference in order to finalize $0 insurance payments. Insurance payments can be finalized for the number of days entered into the preference.

After that time, the preference must be increased (not recommended) or a $0 supplemental payment can be added to finalize if needing to scan an EOB.

If finalizing a $0 payment using the Batch button, this message does not appear if there are other outstanding unfinalized payments. Users must ensure the $0 is listed in the Attached to this Payment grid before finalizing.

When entering a batch insurance payment, the default amount is too big and does not match the EOB amount.

This occurs when other claims have been received, but not finalized. All received claims not finalized are automatically included in the total amount calculation, and users see the claims listed in the Attached to this Payment grid.

1. For this payment, manually change the amount to match the EOB. Select OK on the Edit Insurance Payment window.
2. Click OK on the warning that pops up.

   

3. Manually detach claims not tied to this payment by selecting claim(s) and clicking Detach.

   

4. Once only the correct claims are attached, click OK to finish finalizing the payment.

If payment is always finalized immediately after receiving claims, the amounts and claims when clicking Batch are always accurate, reducing data entry.

Insurance payments that haven't been finalized are indicated with a note in the account module:

What if I cannot receive all of the claims that make up my bulk check/payment and I need to leave for the day?

Do not finalize the payment until all claims have been recieved. This way all claim payments have the same payment date.

I have a bulk payment but the carrier is taking back money from a previous claim. How do I enter the claim?

See Insurance Refunds.