Insurance Payment
Step 1 - Navigate
Select the New Payment option from the Payments drop-down menu.
Step 2 - Payment Details
Note: When posting an Insurance payment, create ONE payment for the FULL amount of the check - you will add ALL claims from the EOB into this one single payment!
Select the payment type 'insurance' and choose the insurance, then enter the basic payment information.
Optional: include a Bonus amount, or an Ignored amount.
Step 3 - Add Claims
Add claims to your payment by entering the superbill number and hitting enter or clicking the + Claims button. The system will not let you add the same claim twice.
Step 4 - Quick Links
You can click on several quick links in the blue claim header. You can open the superbill, the patient, and take actions like editing demographics and insurance, viewing claim history, and deleting the claim from the payment (this deletes all the adjustments, payments, etc that were entered on this payment for that claim).
Detail will show or hide the expanded view of the superbill:
Step 5 - Enter the EOB Charge Line Items
NOTE: For secondary/ tertiary payments, enter only the payment and patient responsibility.
Enter the
Allowed
Adjustments*
Payment
Patient Responsibility (if applicable)
Deductible
Coinsurance
Copayment
*When the Allowed amount is input, the initial Adjustment and CO45 code will automatically populate. For additional Adjustments, you will input the Amount as usual. When you input the new Adjustment code, you should see the appropriate code, title, and description of the adjustment appear. This is a feature to help confirm the appropriate code has been added.
Then use the Bill To drop-down on the right to select a claim disposition; when you save the payment, this is what will happen with the claim next.
Note: on a manually-posted payment, Bill-To will default to the Primary Payer. If no Payer information is present for the patient, it will default to Patient.
Selecting Insurance (e.g. " 1 - Aetna" "2 - CA Medicaid") = Claim goes into the billing queue
Selecting Patient = Claim balance is transferred to the patient
Selecting Settled = Claim balance will be settled
Selecting Crossover = Claim will be marked billed, but not transmitted
*For Crossover you must include a name in the CARRIER box
Step 6 - Save the Payment
Once your payment has been fully input, you should find that the Unapplied box is now green with a balance of $0.00 - any other value in red would indicate an imbalance between the Check Amount and the amount distributed among the Superbills. Assuming all is well, you are now free to Save the payment to apply the funds and the claims' disposition!
Patient Payment - Automatic
NOTE: this workflow does NOT apply to Elation EHR + Billing users that utilize Stripe for payment collection. For Elation EHR + Billing Patient Payment instructions, please refer to this article.
There are a few ways in which a Patient Payment may be Automatically posted:
On the Superbill
If a Copayment Collected amount is entered, a Payment dated to the DOS will be created.
On the Patient Page
Collect Now - Charge Credit Card
If your practice has Stripe set up, this will lead to the Stripe Checkout page. Once this is posted, a Patient Payment will be created (and a receipt will be emailed to the email entered at Checkout)
Online Patient Payment
If the patient pays online per their statement, a Patient Payment will be created
Patient Payment - Manual
*Elation EHR + Billing NOTE*
Steps 1-2 of this workflow will NOT apply to Elation EHR + Billing practices that have the Patient Payment Workflow Update (in which payments automatically flow from EHR to Elation Billing)! For Elation EHR + Billing Patient Payment instructions, please refer to this article.
*General Note*
If a patient's Copay is accounted for on their Superbill, a Payment was automatically created! You can find the Payment 1) through the Patient's History button, or 2) in the Payments tab by searching the patient.
Step 1 - Navigate
Select the New Payment option from the Payments drop-down menu.
Step 2 - Payment Details
Note: When posting an Patient payment, create ONE payment for the FULL amount of the check - you will add ALL claims from the EOB into this one single payment!
Select the payment type 'insurance' and choose the insurance, then enter the basic payment information.
Step 3 - Add Claims
Select "View Patient Claims"
From here, you can view all of the patient's claims on which they have Balance Responsibility (claims with a balance assigned to a Payer will not be present).
Select the Claim(s) you'd like to add to the Payment
Alternatively, add claims to your payment by entering the superbill number and hitting enter or clicking the + Claims button. The system will not let you add the same claim twice.
Step 4 - Quick Links
You can click on several quick links in the blue claim header. You can open the superbill, the patient, and take actions like editing demographics and insurance, viewing claim history, and deleting the claim from the payment (this deletes all the adjustments, payments, etc that were entered on this payment for that claim).
Step 5 - Apply the Payment
Note: We do not advise applying Patient payments before Insurance payments have been applied.
Add the amount of the Payment being applied to the claim in the Payment field.
Step 6 - Bill To
Designated where the claim will be routed next - if the balance has been fully covered, the claim will likely be Settled.
Step 7 - Save the Payment
If the patient's payment has been fully applied, you'll find that the Unapplied box is now green with a balance of $0.00 - any other value in red would indicate an imbalance (typically due to the patient's payment not being fully applied). Assuming all is well, you are now free to Save the payment to apply the funds and the claims' disposition!