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Payment Posting on Account

Module 7

Table of Contents

Accessing the Batch Control Screen .......................................................................................................... 3

Create a New Batch............................................................................................................................... 5

Querying for an Existing Batch ............................................................................................................ 6

Posting Copays – Consecutively ................................................................................................................ 8

Multi-Payment/Adjustment Entry – Additional Tabs ......................................................................... 10

Posting Patient Payments ......................................................................................................................... 14

Auto Distribute Patient Payment ......................................................................................................... 17

Apply Patient Payment to Specific Charge ......................................................................................... 19

Auto Distribution – Additional Tabs................................................................................................... 19

Posting Patient & Insurance Payments .................................................................................................... 31

Post EOB, Contracted & EOB field not set ........................................................................................ 36

Post EOB, Contracted & EOB fields are set ....................................................................................... 39

Post EOB, Managed Care tables are set .............................................................................................. 40

Step by Step to post another payment ................................................................................................. 43

Additional Features .................................................................................................................................. 44

Adjusting off a charge line item ................................................................................................... 44

Posting a zero (0) Payment- ......................................................................................................... 44

Posting ANSI codes manually ..................................................................................................... 45

Changing a Check/EOB number .................................................................................................. 45

Correcting a charge line time that the EOB is stating needs to be corrected in order to be

considered for payment ............................................................................................................... 46

Posting a secondary insurance payment or posting a payment to a ‘Closed’ claim ..................... 47

Calculate Pay/Adj by claim -Additional Tabs ......................................................................................... 50

Step by Step on how to post an Electronic Remittance Advice ............................................................... 50

Additional Tabs on the ‘Remittance File Summary’ screen .................................................................... 52

Reconciling, Printing and Releasing a batch ........................................................................................... 56

Step by Step on how to print a batch ....................................................................................................... 57

Step by Step on how to balance and release a batch ................................................................................ 59

Step by Step on how to delete a payment/adjustment from a batch. ........................................................ 59

Payment Posting

Purpose: To post patient payments that come through the mail, paper EOB’s, and ERA’s (electronic remits).

Accessing the Batch Control Screen

At the Master Menu, select 9-Transaction Entry with a mouse click or by entering '9' in the ‘Enter Selection’

field.

The user selects ‘3 – Batch Control: Patient Reception and Open Item Payment/Adjustment Entry’ with a

mouse click or by entering ‘3’ in the ‘Enter Selection’ field and the Batch Control screen displays.

Create a New Batch

When creating a batch the only fields that are mandatory in this screen are Group Code, Batch Number and

Deposit Date. However, other fields may be required operationally by the practice. The user can choose to enter

a unique batch number or allow the system to automatically assign a sequential number after all applicable fields

are completed and the batch is saved. The user selects the ‘Save’ icon from the Task Bar or the <F4> Function

key from the keyboard.

Step by Step to create a new batch.

In the Group field, <tab> or <enter> through the field if the database code is set to default, or

manually enter the group code. The user can use the mouse to skip to the ‘Deposit Date’ field if

entry in the following field is not necessary.

Batch Number, <tab> or <enter> through the field to use a system. generated number (populated

upon save), or manually enter a number.

Comment, optional free text field.

Deposit Date, insert the current date.

Lock Box ID, optional to enter the lockbox identification.

Default DOS, optional to enter a date of service to default to each transaction line posted in the

batch.

Bank Batch ID, optional to enter the bank batch identification.

Control Totals, <tab> or <enter> through the fields, a zero will populate in the Variance column.

Select the ‘Save’ icon from the Task Bar or the <F4> Function key. Upon save, a batch

number will be assigned.

Querying for an Existing Batch

If a user already has a batch open and would like to find the original batch, instead of opening a new one, please

follow the steps below.

Step by step to query an existing batch:

Master Menu, select ‘9’ Transaction Entry Menu

Select ‘3 – Batch Control: Patient Reception and Open Item Payment/Adjustment Entry’ the screen

will be in 'Insert' mode which means the user will need to start a query.

Start the query/search by selecting the 'Enter Query' icon from the Task Bar or by using the

<F1> Function key on the keyboard.

Enter any of the following information in order to search for an existing batch:

o Batch Number

o Deposit Date

o User ID

Select the 'Execute Query' icon from the Task Bar or the <F2> Function key on your

keyboard.

The Field and Field Description table below further defines each available field.

Field Name Field Description – Batch Control

Group Code This field is for the group number. It will automatically default IF the group default

(MM1.1) is set.

Batch Number

Enter a Batch number (up to 6 characters) or the system will automatically assign a

sequential number after the user ‘Saves’ by selecting the ‘Save’ icon or by pressing the

<F4> Function key. This is a unique number identifying the batch, transactions, and

creator.

Date This is the current system date. Note: This field will automatically populate.

Last Updated This field will default to the date the batch was updated.

Time This field will ‘stamp’ the time the batch was opened or last updated.

User ID This field will auto-populate the user ID that opened the batch OR last updated the batch.

Comment This is a free text field that a user can enter a comment concerning this batch.

Deposit Date This is a required field. Depending on the practice, a user can either enter the current date

or if posting payments, a user may want to enter the date of the actual deposit.

Transaction Total This field will reflect the number of transactions that are posted within a batch.

Lock Box ID Enter the Lock Box number, if posting payments.

Default DOS Enter a Date of Service if all transactions are generally for the same Date of Service. This

DOS will default on all transactions posted, but can still be overwritten.

Number of Accts This field will reflect the number of accounts that have had transactions posted to them

within a batch.

Bank Batch ID Enter the Bank Batch ID, if posting payments.

Hash Total

This field can be used for additional reconciling of balancing charge entry batches. Hash

totals calculate the sum of all CPT codes posted in this batch during charge entry. Alpha

in a procedure code is a zero unless it comes at the end of a procedure code. Examples:

G0008 = 00008, for a total of 8. G0008G = 0000080 which is a total of 80.(More accurate

balancing)

Batch Balance This field can be used for additional reconciling. It is the sum of the variances within the

batch.

Allocated Amount Total amount of payments and adjustments allocated to charges.

Unallocated

Amount Total amount of payments and adjustments unallocated to any charges.

Control Totals There is a field for Payments, Adjustments, and Charges. Manually complete these fields

after the batch has been balanced and prior to releasing the batch.

Actual Amounts There is a field for Payments, Adjustments, and Charges. These fields will automatically

continue to calculate as transactions are being posted in a batch. Use the totals to balance.

Variance

The variance fields calculate the difference between the Control Totals and the Actual

Amounts for each transaction type. If the Variance is zero (0), the batch has been

reconciled and the batch can be released for overnight processing. If the Variance is not

zero (0), the batch must be balanced before being released for overnight processing.

Batch

Status

There are three (3) batch status – H-Hold, E-Release for Editing, and R-Release for

Posting. Note: When a batch is opened the status will automatically default to an ‘H’.

The batch has to be on an ‘H’ before transactions can be posted or changed within that

batch.

Batch Post Month Identifies the specific month when the transactions in the batch are posted, as well as the

Month End the batch will be finalized.

Batch Post Year Identifies the reporting year of the batch and the year the transactions are finalized.

Once all of the information is entered, in the Batch Control screen and it has been assigned a batch number by

either selecting the ‘Save’ Icon from the Task Bar or <F4> Function key on the keyboard, the user is ready to

proceed to post transactions.

Posting Copays – Consecutively

Select the tab at the top of the Batch Control screen or use the <F9> function key to

access the ‘Multi-Payment/Adjustment Entry’ screen. This screen can be utilized if all payments that are being

posted are ‘true copays’. Note: In order to post copayments on this screen, the following fields are required.

Attending Doctor

Location

DOS

The following is a table of Field Names and Field Descriptions.

Field Name Field Description – Multi-Payment/Adjustment Entry

Batch The batch number will display in this field.

Group This field is where the group code will be entered.

Account This field is where the patient’s account number will be entered.

AtDoc This field is where the attending doctor will be entered.

Location This field is where the location will be entered.

Type This field is where the type of transaction will be entered ‘P’.

Procedure This field is where the method of payment code will be entered.

Check Number

A window will pop-up once the Procedure field has been entered. Enter the check

number. This field can also be utilized to enter what credit card was used, if paid by

credit card.

Insurance This field would be used if the payment was from an insurance company. This field is

usually not utilized as insurance payments are posted on a different form.

Unit Amt This field is where the dollar amount of the payment is entered.

Error This field will populate an ‘E’ if the line item has been error corrected.

DOS This field is for the Date of Service that the copayment is to be applied.

IT This field will display the Insurance Type that is tied to the patient’s primary

insurance.

Exc Code This field will display an exception code if one is attached to the patient’s account.

Account Balance This field will display the patient’s account balance that is patient responsible.

Insurance Balance This field will display the balance that is due from the insurance on the patient’s

account.

Pending Balance After the payment line has been saved, the Pending Balance will change to reflect the

Balance minus the payment that was posted.

Multi-Payment/Adjustment Entry – Additional Tabs

Pending Detail . This tab or <F8> will display all of the transactions that

are still in a batch on any given account.

Posted Detail . This tab or <F9> will display all of the transactions that

have been posted to an account after a batch has been released and the nightly post process has been

performed.

Request Claims & EOB’s . This tab or <Shft F7>will enable a user to

print a paper CMS1500 form if a patient needs a copy to file to their insurance company.

Refund Payee . This tab would only be utilized if refund checks are

generated out of the system.

Posting Patient Payments

Method # 1- MM9.3, Open batch, Auto Distribution <F11> - This path would be used if only patient

payments, that come back through the mail, are being posted within a batch.

Method # 2 MM9.3, Open batch, Open Item Posting Menu <Ctr g>, #1 Cal Pay/Adj By Claim– This

path would be used if patient payments, that come back through the mail, and insurance paper EOB’s are

being posted in the same batch.

Step by Step for Method # 1 ‘Patient Payments only’

Master Menu 9, Sub Menu 3

Open Batch or find existing batch

Choose the Auto Distribution tab or <F11> on the keyboard from

the Batch Control Screen.

(MM9.3, F11)

Enter the patient’s account number <tab> or <enter>. This will populate the following fields:

o Patient’s name

o Balance – The patient’s balance

o Insurance Balance – The balance out to insurance

o FC -Financial Class

o Ex Code - Exception code if one is attached to the patient’s account

o Msg Code – Message code if one is attached to the patient’s account

o Cnt – The number of times the Msg Code is to print on a patient’s statement, if set

o Hold Stm – Hold Statement if one is set on the patient’s account

The below screen shot will populate.


Field Name Field Description –Auto Payment Distribution

Group The group code will automatically populate if defaulted on MM1.1.

Batch This field will display the batch number that payments are being posted.

Account The patient’s account number will be displayed in this field.

Name The patient’s name will display in this field.

Balance This field will display the balance due from the patient.

Insurance

Balance This field will display the balance due from the insurance.

FC The financial class that is linked to the patient’s account will display in this field.

Ex Code If there is an Exception Code attached to the patient’s account it will display in this

field.

Msg Code If a specific message code has been attached to this patient’s account it will display in

this field.

Cnt

This field works along with the Msg Code field. If a Msg Code has been attached to the

patient’s account the Cnt field will allow a user to enter how many statement cycles the

message should appear on the patient’s statement.

Hold Stm If an account has a value entered in this field on the Patient Account screen, it will

display in this field.

Payment

Amount This field is where the amount of the payment will be entered.

Pay Code This field is where the internal payment code will be entered according to the method of

payment.

Select ALL DOS This button will allow the payment to be automatically distributed to the oldest

charge(s).

Deselect ALL

DOS

This button will appear after the ‘Select All’ button is activated. This can be selected if

the user wishes to deselect the distribution of the payments.

DOS Date of Service –use for a specific date of service

AtDoc Attending Doctor – use for a specific Attending Doctor

DOS This field will display the Date of Service for the charge line item(s). Note: The charges

will display with the oldest DOS first.

Chg Code This field will display the CPT code of the charge.

Chg Amount This field will display the dollar amount of the charge.

Item Balance This field will display the balance of the charge line item.

Responsibility This field will display who is responsible for this line item. The options are ‘P’ for

patient, ‘I’ for insurance, or an ‘X’ if the charge is still in the claim rejection screen.

Doc Code This field will display the doctor the charge was billed out under.

Loc This field will display the location where the charge was rendered.

Pay Applied This field will display the amount of payment that was applied to the charge.

Unapplied

Amount

This field will display any unapplied money if the amount that was paid is greater than

the line item(s) where the payment was applied.

Chgs Selected This button is used to confirm that the line items selected are the DOS’s that the

payment(s) need to be applied too.

Check # This field is for the check number if the payment was made by check.

Check Date This is a required field where either the date of the check or the current system date will

be entered.

Auto Distribute Patient Payment Step by Step to post a patient payment that is paid by the patient’s statement.

MM9.3

Open Batch or find an existing batch

Click on Auto Distribution or use the <F11> function key

Enter the patient’s account in the ‘Account’ field <tab> <enter>. This will populate:

Enter the amount of the payment in the ‘Pay Amount’ field

Enter the payment code for the method of payment in the ‘Pay Code’ field

If the entire payment should be automatically distributed to the oldest charges first, either <tab> or

<enter> or Click on the ‘Select All’ button. By activating the ‘Select ALL DOS’ button,

the system will apply a check mark to all of the open charge line items that have a balance that can be

paid with the dollar amount of the payment.

Note: If it is determined that these are not the charge line items that the payment needs to be applied to the

user can click on the ‘Deselect ALL DOS’ button and the check marks will be removed.

Once the ‘Select ALL DOS’ button has been activated and the check marks are applied to the charge

line items, and it is determined that these are the charge line items that need to have the payment(s)

applied against, the user will either <enter> or Click on the ‘Chgs Selected’ button,

the cursor will default to the ‘Check #’ field.

If the method of payment was a check, enter the check number in this field. Note: This field could

also be utilized to enter an authorization number from a credit card it that was the method of

payment.

Enter the ‘Check Date’, this is a required field. Please see screen shot below.

Save

Apply Patient Payment to Specific Charge

Step by Step for applying patient payment to specific charge line item.

Enter the patient’s account in the ‘Account’ field <tab> <enter>.

Enter the amount of the payment in the ‘Pay Amount’ field <enter>.

Enter the payment code for the method of payment in the ‘Pay Code’ field <enter>.

Using the mouse, click on each charge line item that the payment needs to be applied against. Note:

When a payment is more than the Item Balance of the line item that is being selected, the Unapplied

Amount , will display how much money remains to be applied to the remainder of the

charge line item(s). Once all of the money has been applied, the ‘Unapplied Amount’ will be zero

(0).

Once the check marks are applied to the charge line item(s) <enter> or Click on the ‘Chgs Selected’

button, the cursor will default to the ‘Check #’ field.

Complete the ‘Check #’ field if applicable.

Enter the ‘Check Date’. This is a required field.

Save.

Auto Distribution – Additional Tabs

This tab or <F11> will show the history of the patient’s appointments.

This tab or <F12> will allow a user to enter a comment on the patient account

screen.

When the application displays the form, the following fields will auto-populate from the Patient Account

screen:

‘Group’, ‘Account’, ‘Patient Name’, ‘Exception’ ‘Financial Class’, ‘Balance’, ‘Follow Up’

The ‘Date’ and ‘Userid’ display after a comment is entered and saved based on system date and the

credentials of the user logged into the application.

The user can read all comments at this time and/or add new comments. The cursor is in the ‘Initial’ field,

which refers to the user’s initials, but is not a required field, however if the user chooses to enter their initials

they can later query for just their comments.

Action Codes

Purpose: To comment in a standardized fashion and allow reporting on frequent actions at an account level.

The user can <tab> or <enter> to the ‘Action Code’ field which represents ‘Action Code’. If the client uses

‘Action Codes’, (added during Master Tables training), the user can manually enter an ‘Action Code’, pulling

a partial comment that is already added to the ‘Action Codes’ Master Table. There are two ways to add an

action code.

If the ‘Action Code’ is unknown, the user can click the LOV button. A blank window opens in

‘query’ mode.

The user selects <F2> Function key from the keyboard or the ‘Execute Query’ icon on the task bar

and all ‘Action Codes’ will be listed.

The user can scroll through the available codes and description or conduct a query by selecting <F1>

Function key on the keyboard or the ‘Enter Query’ icon on the task bar to clear the window. The

user selects <tab> to move to the ‘Description’ field and enters search parameters with the Clinix Wildcard,

the '%’ sign as shown here:

The user selects <F2> Function key from the keyboard or the ‘Execute Query’ icon on the task

bar and the query displays the following:

The user highlights the desired ‘Action Code’ and can activate the ‘Sticky Cursor’ feature. This is

accomplished by double clicking on the code or selecting the ‘Save’ icon or by pressing the <F4>

Function key from the keyboard to bring the ‘Action Code’ back to the comment record. The user can click

at the end of the comment that auto populated and complete the comment.

If the user wants to enter a unique comment, <tab> past the ‘Action Code’ column and start typing the

comment. If more than one line is needed, the comment will continue on the next line or the user can use

<enter> and the cursor will go to the next line.

When the new comment is complete, the user ‘Saves’ by selecting the ‘Save’ icon or the <F4> Function

key, the system will automatically stamp the current date and the userid. Then select from the Task Bar

or <Ctrl Q> from the keyboard to return to the previous screen. When the user refreshes the account, the last

comment entered will populate in the comment field or a tagged comment as explained below.

Tagged Comment

Purpose: To display a preferred comment on multiple screens throughout the application.

ClinixPM also has a feature that will give users the ability to ‘tag’ a comment, as the preferred comment to

always display on that account. When a comment on the ‘Account Comments Inquiry’ screen is ‘tagged’ or

checked, it will display instead of the standard last comment entered. The user selects the appropriate

comment on the ‘Account Comments Inquiry’ screen to tag by clicking the box to the left of the comment in

the ‘Tag’ column.

This tab or <Shft F7>will allow a user to go to the patient’s account if any of

the patient’s demographic information needs to be updated.

This tab or <Shft F8> will allow a user to access the patient’s insurance

record.

This tab or <Shft F11> will allow a user to access all transactions that

have been posted to the patient’s account after a batch has been released and the nightly post process

has taken place.

This tab or <F10> will allow a user to access all transactions that are still in a

batch that has not been released and the nightly post process has not taken place.

This tab or <F8> would be utilized if the patient is making a payment using two

different methods of payment. For example; patient might pay part in credit card and part in check.

By clicking on this tab or by using <F8> from the keyboard, the system will move back one screen

and retain the patient’s account number. The user would then follow the same steps and enter the 2nd

payment amount and the 2nd

payment method and apply the payment.

This tab or <F9> will allow the user to post a patient payment to a different

patient’s account. By clicking on this tab or by using the <F9> key from the keyboard, the system

will move back one screen and the ‘Account’ field will be blank.

o Enter the patient’s account number

o Use the Step by Step for Method # 1 section

o Save

This tab or <F6> will allow the user to clear what has been entered on the

screen if it might have been entered incorrectly. By clicking on this tab or by using the <F6> key

from the keyboard, the system will retain the patient’s account number. The user can then re-enter

the payment information on the same account or the account number can be changed to a different

account number by clicking in the ‘Account” field.

This tab or <F3> will allow a user to advance to another screen where a paper

remit can be posted as explained in the next section ‘Posting a Paper Remit’.

Posting Patient & Insurance Payments

Method # 2 – This path would be used if patient payments, that come back through the mail, and

insurance paper EOB’s are being posted in the same batch.

MM9.3

Open batch or find existing batch

‘Open Item Posting Menu’ <Ctr g>

#1 – Cal Pay/Adj by Claim

This is the screen where paper EOB’s will be posted, which will be explained step by step below. The

advantage of going through this path will allow the user to post a paper EOB from the below screen and

then if a patient payment needs to be posted a user can click on the Auto Dist tab

or use the <F3> function key. This will take the user back to the screen where

a patient payment can then be posted.


Field Name Field Description – Calculate Pay/Adj by Claim Screen

Chk/EOB # This field is where the check number or EOB number will be entered.

Chk Date This field is where the date of the check or the date check is being posted will be

entered.

Account This field is where the patient’s account number will be entered for the payment that is

being posted, patient name will populate in next field.

Balance This field will display the balance of the patient’s account.

Ex This field will display an Exception Code if one is attached to the patient’s account.

Hold Stm This field will display if there is any value set on the patient’s account.

Msg This field will display a Message Code if one is attached to the patient’s account.

Count This field will display the number of times a message should appear on a patient’s

statement if one has been set.

Fin Class This field will display the patient financial class which is tied to the patient’s primary

insurance.

Network This field is used if a network has been set up in the master table.

Init. This field is where the user can put their initials for follow up.

Atcd Attachment code

Atch# Attachment number

Ins1 This field will display the insurance key code of the patient’s primary insurance, the

insurance name will display in the next field.

Mst Code This field will display the primary insurance master code.

Ins2 This field will display the insurance key code for the patient’s secondary insurance, if

applicable. The insurance name will display in the next field.

Mst Code This field will display the secondary insurance master code.

Ins3 This field will display the insurance key code for the patient’s tertiary insurance, if

applicable. The insurance name will display in the next field.

Mst Code This field will display the tertiary insurance master code.

Claims Block

Cover Amt This field will display 0.00 if a claim is open and if the claim is closed it will display

the dollar amount of the actual claim as displayed in the Claim Amt field.

Status This column will indicate the status of the claim. Options are ‘O’ for open, ‘C’ for

closed and ‘D’ if the claim was demanded to the printer.

Denied

This field will display the ‘destination’ of the claim. Options are:

Y – Deny this claim and stop the secondary filing

S – Deny this claim and file the secondary claim

R – Refile this claim

N – Default Entry when the screen is requested

Doc The doctor the claim on.

Ins The insurance the claim was billed.

Claim Amt The total dollar amount of the claim.

From Date The from Date of Service

To Date The to Date of Service

Clinix Claim # This is the internal claim number that the system will assign with a claim goes out to

an insurance company.

Lab Lab procedure

A This field will display the Assignment field as it is marked on the insurance company

master, MM1.4. The options are ‘Y’ for Yes and ‘N’ for No.

Charge Items on a Claim Block

DOS This field will display the Date of Service for the charge line item.

Procedure This field will display the CPT code that was billed to the insurance company.

MD This field will display a modifier, if one was attached to the charge line item.

MD This field will display a modifier, if one was attached to the charge line item.

Description This field will display the description of the CPT code.

Loc This field will display the location where the service was rendered.

Doc This field will display the Doctor the charge was posted to.

Amount This field will display the dollar amount of the charge line item.

IT This field will display the Insurance Type that is linked to the patient’s primary

insurance.

Item Balance This field will display the remaining balance of the charge line item.

Appeal This field can be utilized if a charge line item is being appealed.

Payment/Adjustments against a Charge Item Block

Note: If there is a Managed Care table set up for an insurance company or if the

Contract field and EOB field on the insurance master, MM1.4 have a ‘Y’ entered

in them the user will not see the fields in the ‘Payment/Adjustments against a

Charge Item’ block until after a payment has been posted or the hidden fields

that will appear have been completed. Both of these methods will be explained

step by step within this document.

DOS

This field will display the Date of Service that the payment is being applied to. Note:

There will be two (2) lines. One will be for the payment and the next one will be for

the adjustment. If only an adjustment is being posted, the user will enter the

adjustment information on the first line.

Ins

This field will display the Insurance Key Code of the insurance company that paid on

the charge line item. Note: There will be two (2) lines. One will be for the payment

and the next one will be for the adjustment. If only an adjustment is being posted, the

user will enter the adjustment information on the first line.

P/A

The field is for the type of transaction that is being posted. Options are ‘P’ for

Payment or ‘A’ for Adjustment. Note: There will be two (2) lines. One will be for the

payment and the next one will be for the adjustment. If only an adjustment is being

posted, the user will enter the adjustment information on the first line.

Procedure

This field is where the payment procedure code will be entered. Note: There will be

two (2) lines. One will be for the payment and the next one will be for the adjustment.

If only an adjustment is being posted, the user will enter the adjustment information on

the first line.

Description

This field will display the description of the payment or adjustment code that was

entered into the procedure field. Note: There will be two (2) lines. One will be for the



Amount

This field is where the amount of the insurance payment will be entered. Note: There

will be two (2) lines. One will be for the payment and the next one will be for the

adjustment. If only an adjustment is being posted, the user will enter the adjustment

information on the first line.

Ops The OPS field pretains to Ohio Medicaid if they are secondary to any insurance other

than Medicare.

Item Balance

This field will reflect the balance of the charge line item after the payment or

adjustment has been entered. Note: There will be two (2) lines. One will be for the



Additional fields on the Calculate Pay/Adj by Claim screen

Group This field will display the group code that the patient’s account is in. Note: This field

will default if the group code is set on MM1.1

Chk Tot

This field will display the total dollar amount of the payments that are being posted to

the check/EOB number. As long as the check number or EOB number is the same as

the previous payment, the check total will continue to calculate. When the last patient

on the check or EOB has been posted, the dollar amount in this field should equal to

the dollar amount of the check. This will allow the user to ensure that all payments on

that check or EOB have been posted.

Batch This field will display the batch number the payments/adjustments are being posted in.

Claim Total This field will display in red the total dollar amount that has been posted to this

patient’s account for the check or EOB.

Ansi Block

Ins Code This field will display the insurance key code for the claim billed out.

Ins Seq This field will display the filing sequence for insurance that the claim is billed out.

Reas1-Reas9

These fields will be utilized to enter any ANSI codes that the system does not

automatically post to a charge line item. Note: The ANSI codes that the system will

automatically post, if the Contract & EOB fields are marked with a ‘Y’ on the

insurance master, MM1.4, are CO45, Pr1, Pr2, and/or Pr3, which will be discussed

within this document.

Remark 1 -5 Code These fields will be utilized to enter any ANSI remark codes, if needed, to a charge

line item.

Close Claim? These fields can be utilized if a CLAIM needs to be closed at the time

an insurance payment is being posted. These fields will be discussed within this

document. Note: These fields are only available for the claim level, not for

individual charge line items.

Status

This field indicates the status of the claim. The options are:

o O = Open

o C = Closed

Below will give step by step on how to post an insurance paper EOB one of three ways.

If the Contracted and EOB fields are not set to a ‘Y’ in MM1.4

If the Contracted and EOB fields are set to ‘Y’ in MM1.4

If a Managed Care table has been set up for the insurance carrier in MM1.14

Post EOB, Contracted & EOB field not set Step by Step to post a paper EOB if the Contracted and EOB fields are not set in MM1.4

Master Menu 9 – Transaction Entry

Sub Menu 3 – Batch Control: Patient Reception and Open Item Payment/Adjustment Entry

Open a batch or search for an existing batch

‘Open Item Posting Menu’ tab,

# 1 – Cal Pay/Adj By Claim

o D = Demand Claim

DN

This field indicates what a user would like for the next step to be with this claim. The

options are:

o Y = Deny this claim and stop the secondary filing

o S = Deny this claim and file the secondary claim

o R = Refile this claim

Den Reason

Claim Reference

No

Chk/EOB # - Enter either the check number or the EOB number in this field, <tab> or <enter>.

Chk Date – Enter the check date in this field, <tab> or <enter>. Note: A user can enter either

the actual date of the check/EOB or the current system date.

Account – Enter the account number of the patient the payment is being posted for <tab> or

<enter>. Note: This step will automatically populate the follow fields.

Go to the ‘Claims’ block by one of the following actions

o Use <tab> or <enter> three (3) times

o Use the <F8> function key, OR,

o Click on the ‘Next Block’ Icon,

Claims Block – This block will display the claims that are attached to the patient’s accounts. Four (4)

claims will be displayed. The user can either scroll down with the scroll bar or a claim can be found by

performing a query in the ‘Claims’ block to search for the DOS that the insurance is paying on. In order

to perform a query follow the below steps:

o Either Click on the 1st question mark Icon, , or use the <F1> function key.

o Once the screen is in a query mode, the user can click in the ‘From’ field in the

‘Claims’ Block and enter the date of service the insurance company is paying on,

o Execute the query, by either clicking on the 2nd

question mark Icon, , or

using the <F2> function key. When performing a query by the DOS, the system will

just display any claims for that specific date of service.

Once the DOS has been located, the user can either click on the blue selector button, to the

left of the claim, or the user can <tab> or <enter>, or by using the mouse, click on the blue

selector button, or click on the ‘Next Block’ Icon.

When one of these four (4) actions takes place, the cursor will advance to the ‘Charge Items on

a Claim’ block. Note: When the cursor advances to the next block, the blue selector button will

become red . This will allow a user to keep track of the claim they are posting.


In this block the charge line item(s) that make up the Claim Amount will be displayed.

Select the charge line item that the insurance company is paying on by either clicking on the

blue selector button to the left of the charge line item, or by <Enter>. Note: When the cursor

advances to the next block, the blue selector button will become red . This will allow a user

to keep track of the charge line item they are posting.

Payments/Adjustments against a Charge Item Block

The Date of Service will default in the ‘DOS’ field

The Insurance Key Code will default in the ‘Ins’ field

A ‘P’, for payment, will default in the field to the right of the ‘Ins’ field. This field represents

the type of transaction.

The payment code that is attached to the insurance master, MM1.4, will default in the

‘Procedure’ field.

The description of the payment code will default in the ‘Description’ field.

The user will either click in the ‘Amount’ field, or <enter> three (3) times to the ‘Amount’ field

and enter the amount of the payment.

Hit the down arrow on the keyboard or click on the ‘Next Record’ Icon, . This will advance

the cursor to the line below the payment where an insurance adjustment can be posted.

Save

To post the next payment, click on the Clear Screen tab, or hit the F10 function

key. This will advance the cursor back to the Chk/EOB# field. Note: The previous check

number will default. If the next payment is on the same check or EOB, hit the <Tab> or

<Enter> and repeat the payment posting process as stated above. If the check or EOB number is

different, the user will override the defaulted number.

Post EOB, Contracted & EOB fields are set Step by Step to post a paper EOB if the Contracted and EOB fields are set to ‘Y’ in MM1.4

MM9.3




































There will now be hidden fields that will appear. They are as follows:

o Allowed

o Coinsurance

o Deductible

o Copay

o Withhold

Enter the ‘Allowed’ amount from the EOB <enter>

Enter the ‘Coinsurance’, if applicable. Note: If an insurance company bundles the coinsurance

instead of stating the dollar amount, the user can enter the percentage of coinsurance and the

system will automatically calculate the coinsurance amount. For example; if the patient’s

coinsurance is 20%, enter 20% in the ‘Coinsurance’ field, <Enter> and the system will

automatically populate the dollar amount. <Enter>

Enter the ‘Deductible’, amount, if applicable. <enter>

Enter the ‘Copay’ amount, if applicable. <enter>

Enter the ‘WithHold amount, if the EOB states there is a true withhold. <enter>

Once the user enters past the withhold field, the system will automatically post the payment and

adjustment for the charge line item.

Save

Post EOB, Managed Care tables are set Step by Step on posting a payment with Managed Care table set in MM1.14

MM9.3















There will now be hidden fields that will appear. They are as follows:

o Allowed

o Coinsurance

o Deductible

o Copay

o Withhold

The ‘Allowed’ field will automatically default to the allowed amount, for the CPT code, that is

set in the managed care table, MM1.14. Note: If the insurance company did not allow the

amount that is defaulted, the user can override the amount. If the amount is changed, the user

will receive a report back the next day. This report can be utilized to contact the insurance

company to follow up as to why they did not pay according to the contracted amount.

Enter the ‘Coinsurance’, if applicable. Note: If an insurance company bundles the coinsurance

instead of stating the dollar amount, the user can enter the percentage of coinsurance and the

system will automatically calculate the coinsurance amount. For example; if the patient’s

coinsurance is 20%, enter 20% in the ‘Coinsurance’ field, <Enter> and the system will

automatically populate the dollar amount. <Enter>

Enter the ‘Deductible’, amount, if applicable. <enter>

Enter the ‘Copay’ amount, if applicable. <enter>

Enter the ‘WithHold amount, if the EOB states there is a true withhold. <enter>

Once the user enters past the withhold field, the system will automatically post the payment and

adjustment for the charge line item.

Save

Step by Step to post another payment

Click on the Clear Screen tab, , or use the <F10> function key. This will

clear the previous account information and the check number/EOB number will be retained. If

another payment is on the same EOB, post the payment as directed above. Note: There are two

(2) fields that will allow the user to ensure that all the payments are being posted on an EOB.

o Chk Tot - This field will continue to calculate the dollar amount of the payments as

other patient payments are being posted from the same check or EOB. When the last

payment is posted and saved, the check total amount should equal the amount of the

actual check or EOB. This gives the user a method of making sure that all payments

are posted.

o Claim Total – This field will reflect the dollar amount that is posted to a specific

patient. This dollar amount total will be in red.

If the next insurance payment is on a different check or EOB, the user can enter the next

account number and continue to post as indicated above.

Note: When posting Allowed, Coinsurance, Deductible, Copay by completing the appropriate fields, the

system will automatically post the ANSI codes of CO45, PR1, PR2, and/or PR3. When a patient has a

secondary insurance that can go electronically the ANSI codes are required in order to avoid having the

claim denied. If any other ANSI code(s), other than the ones the system automatically posts, need to be

entered the cursor will need to be on the charge line item that needs the manual ANSI code posted. When

the charge line item is selected.

Also, if the insurance payment is a Medicare payment and the patient’s secondary can go electronically,

the ICN number from the Medicare EOB will need to be on the secondary claim to avoid having the

claim denied. In order to ensure the ICN number is posted, there is a field on the Medicare insurance

master record, ‘CRN Required’, that must have a ‘Y’ entered in the field. When this is marked with a

‘Y’, the user can use the available field to enter the ‘Claim Reference No’.

Additional Features

Adjusting off a charge line item - If a charge needs to be adjusted off due to the insurance company

completely denying the charge, the following steps can be completed.

o The user will enter a zero (0) in the ‘Allowed’ field. This action will default the cursor to the

‘Payments/Adjustments against a Charge Item’ block. The ‘DOS’ field and the ‘Ins’ field will

automatically populate.

o Enter an ‘A’, for adjustment, in the field to the right of the ‘Ins’ field. <Enter>

o Enter the appropriate adjustment code in the ‘Procedure’ field. <Enter> The description of the

adjustment code will populate in the ‘Description’ field.<Enter>

o Enter the dollar amount of the adjustments in the ‘Amount’ field. <Enter>.

o Ops – This is a field that is utilized for Ohio providers. If not applicable enter past this field.

The ‘Item Bal’ field should then be zero (0).

o Save

Posting a zero (0) Payment- If a user needs to post a zero (0) payment the following steps can be

completed.

o The user will enter a zero (0) in the ‘Allowed’ field. This action will default the cursor to the

‘Payments/Adjustments against a Charge Item’ block. The ‘DOS’ field and the ‘Ins’ field

will automatically populate.

o Enter a ‘P’, for payment, in the field to the right of the ‘Ins’ field. <Enter>

o Enter the appropriate payment code in the ‘Procedure’ field. <Enter> The description of the

payment code will populate in the ‘Description’ field.<Enter>

o Enter a zero (0) in the ‘Amount’ field. <Enter>.

o Ops – This is a field that is utilized for Ohio providers. If not applicable enter past this field.

The ‘Item Bal’ field should not change.

o Save

Posting ANSI codes manually

The system will automatically post the following ANSI codes if the ‘Contracted’ and ‘EOB’ fields are

marked with a ‘Y’ in MM1.4.

o CO45

o PR1

o PR2 and/or PR3

To post any other ANSI codes the following steps will need to be completed.

o On the ‘Calculate Pay/Adj by Claim’ screen, place the cursor on the charge that will need

the ANSI code posted manually.

o Click on the ‘Denial Codes’ tab or use the <F6> function key. This will default the cursor

to the Reas 1 field. Enter the appropriate ANSI ‘Prefix’ Code. <Enter>

o Enter the appropriate ANSI code in the ‘Code’ field. <Enter>

o Enter the dollar amount associated with the ANSI denial.

o Save

Changing a Check/EOB number

If an insurance company pays on the same patient however; pays with separate checks/EOB’s. A user can

change the check or EOB number by completing the following steps.

o When the cursor is in the ‘Allowed’ field, enter a Ctrl A on the keyboard.

o When entering the Ctrl A demand, the following pop up will appear. Enter the new

Check/EOB number. <Enter>

o This will change the Check/EOB number.

o Enter the payment and adjustment.

o Save

Correcting a charge line time that the EOB is stating needs to be corrected in order to

be considered for payment

If an insurance company does not pay on a line item stating that something on the charge needs to be

corrected, a user can correct the charge line item at the time payments are being posted by completing the

following steps.

o Click on the tab or use <Ctr H> on the keyboard. The

system will advance to the ‘Account Detail Information’ screen.

o Highlight the charge line item that needs the correction performed.

o Use the tab or <F11> function key.

o Make the necessary change(s). For further information please refer to Module 6.

o Save

Posting a secondary insurance payment or posting a payment to a ‘Closed’ claim

If a secondary insurance pays prior to the primary insurance or if an insurance payment needs to be posted to

a closed claim the following steps can be completed.

o On the ‘Calculate Pay/Adj by Claim screen, the user will click on the

tab or enter <Shft F7> on the keyboard. The system will advance to the following screen..

o The Group and Batch fields will automatically populate and the cursor will default to the

‘Check/EOB Nbr’ field.

o Enter the Check number/EOB number. <Enter>

o The cursor will default to the ‘Check Date’ field. This is a required field. A user will either

enter the current system date or the date the deposit will be made. <Enter>

o The cursor will default to the Account field. Enter the patient’s account number. <Enter>

o At this time the following fields will populate:

FC - Financial class

Ex – Exception code, if one is attached to the patient’s account

Hold Stm – This field will display what is populated in the hold statement

field on the patient’s account

Msg – This field will display a statement message code if one is attached to

the patient’s account

Cnt – This field will display the number of times a user has asked for the

Message to appear on a patient’s statement.

Patient’s name

Bal – This field will display the patient’s account balance

o After all of the above fields are completed the user will either hit the <F8> function key

twice or <Tab> or <Enter> until the ‘All Charge Items’ block displays the patient’s charges.

Note: This screen does not have the F8-Change Blocks tab however; a user can hit the

F8 function key instead.

o The ‘All Charge Items’ block will display all of the charges on a patient’s account. The line

item that is selected will be indicated by the raised blue button, that Clinix refers to as the

‘Blue Selector Button’. The user can view all of the charges by either using the down arrow

on the keyboard or using the scroll bar to the right of the Item Bal field.

o Once the charge line item has been found, that the payment needs to be applied to, the user

can either click on the blue selector button on the charge line item or can <Enter>.

o The cursor will advance to the ‘Enter Payments/Adjustment against a Charge Item’ block

and the charge line item that was selected will change the selector button from blue to red in

order for a user to know which line item they are currently working on.

o The DOS will automatically populate from the chosen charge line item. The user will enter

the insurance key code in the ‘Ins Code’ field. <Enter>.

o The user will enter the type of transaction in the ‘P/A’ field. The choices are ‘P’ for

payment or ‘A’ for adjustment.

o Procedure, the user will enter the internal code for the payment or adjustment in this field,

<Enter>.

o The Description field will automatically populate with the procedure description as set in the

database.

o The cursor will default to the ‘Amount’ field. The user will enter the amount of the

payment/adjustment in this field. The ‘Item Bal’ will default to the difference between the

charge amount and the payment or adjustment. Note: The OPS field pretains to Ohio

Medicaid if they are secondary to any insurance other than Medicare.

o Once the payment or adjustment has been posted to the charge line item, the user will Save.

If there is another charge line item in the ‘All Charge Items’ block, the cursor will default to

the next charge. If the user needs to post a payment or adjustment to that charge, they will

repeat the above process for each charge that a payment or adjustment needs to be posted.

Calculate Pay/Adj by claim -Additional Tabs

After a payment has been posted and saved, the user can click on the Clear Screen tab

or use the <F10> function key and the screen will clear so that the next account number can be entered.

By clicking on this tab, or using <Shft F8>, a user can view the transactions that have

been posted to a specific account. Pending transactions are transactions that are still in a batch and the

nightly post process has not been performed.

By clicking on this tab or using the <Shft F11>, a user can enter a comment on this

patient’s account.

By clicking on this tab or using the <Shft F12>, a user can view a patient’s insurance

information.

Note: Some insurance companies will send both a paper EOB and also an ERA (electronic remittance

advise). If there is an ERA loaded in the system that matches the check or EOB #, the system will

automatically default to the ERA screen when the check or EOB number is entered on the ‘Calculate

Pay/Adj by Claim’ screen. This will allow a user to post the payment electronically instead of manually.

Please see below on how to post an ERA.

Step by Step on how to post an Electronic Remittance Advice This method will allow a user to post an insurance payment electronically.

MM9.4 – This screen will allow a user to post ERA’s. Either one check number can be entered

on this screen, or by clicking on the F2- Load Checks tab , or using the

<F2> function key, all checks that are loaded in a database will populate on the ‘Remittance

File Summary’ screen.

Field Name Field Description – Remittance File Summary

Check #

If only one check needs to be posted, the check number can be entered in this field.

However; if a user would like to see all checks that are available to post, click on the

F2-Load Checks tab.

Amount This field is for the dollar amount of the check.

Check Date This field is where the check date will be entered.

State This field will display the state the check was issued from.

Type of Pay This field will display the type of insurance company that paid.

Method

Indicates how an ERA was received. Options are

o NON – Non-payment

o CHK - Check Payment

o ACH – EFT Payment

Payor # This field will display the Payor ID # of the carrier that issued the payment.

Prov No/Tax ID This field will display the provider’s number. Either the NPI or Tax ID# according to

how the carrier requires the identification numbers.

Payor Name This field will display the Payor’s name.

Check Number This field will display all of the checks that are available to post if the user choose to

click on the F2-Load Checks tab.

Check Date This field will display the date of the check from the carrier.

State This field will display the state the check was issued from.

Type of Pay This field will display the type of insurance company that paid.

Method Indicates how an ERA was received. Options are

o NON – Non-payment

o CHK - Check Payment

o ACH – EFT Payment

Payor # This field will display the Payor ID # of the carrier that issued the payment.

Prov #/Tax ID This field will display the provider’s number. Either the NPI or Tax ID# according to

how the carrier requires the identification numbers.

Total RC-Amt This field will display the total amount of the EOB.

Proc PD – Amt This field will display the dollar amount of the check that was issued to the provider.

Proc Adj Amt This field will display the dollar amount of the adjustments.

Check Amount This field will display the total dollar amount that was paid to the provider.

Payor Name This field will display the name of the insurance company that issued the check.

Carrier Check

Amount This field will display the check amount the carrier sent in the 835.

Additional Tabs on the ‘Remittance File Summary’ screen

o This tab or <F6> function key can be utilized to

delete/remove a check from the screen. Note: Once a check has been deleted it will

need to be reset by programming.

o By clicking on this tab, or using the <F3> function key, the

user will have the ability to print a paper copy of the remittance.

Click on the blue selector button to the left of the check number that needs to be posted.

The system will advance to the ‘Remittance File Maintenance’ screen, explained below. This

screen will give a user the ability to view all of the payments and adjustments that will be posted

in this remit. If there are any fields that are blank, the user will need to complete the field with

the necessary information. Note: Any transaction line that has a blank field, as indicated in the

red box area below, will not post in the transfer process.

Field Name Field Description – Remittance File Maintenance

Group This field will display the group code.

Account This field will display the patient’s account number that the payment/adjustment is to be

posted.

Type This field will display the type of transactions. The options are ‘P’ for payment and ‘A’

for adjustment.

Refer This field will display the payment/adjustment code.

Check Number This field will display the check # that is attached to the ERA.

Amount This field will display the dollar amount of the payment or adjustment.

Provider# This field will display the provider number that is related to this ERA.

Doctor This field will display the doctor number the services were rendered by.

Cpt Code This field will display the CPT procedure code that the payment/adjustment is attached

to.

From DOS This field will display the Date of Service of the charge.

RI

If a payment or adjustment needs to be flagged to NOT post on the electronic remit, the

user can manually enter an ‘N’ in this column. This action would stop the payment or

adjustment from being posted in the transfer process.

Policy This field will display the policy number of the patient the payment/adjustment is being

posted to.

Charge

Amount

This field will display the dollar amount of the charge that the payment/adjustment is

being posted to.

CRN This field will display the ICN number of remit.

By clicking on this tab, or by using the <F10> function key,

the system will advance to the ‘Remittance Transfer Options’ screen.

Field Name Field Description – Remittance Transfer Options

Group This field will display the group code.

Batch The batch number can either be manually entered in this field or the next batch number

in sequence will default when the screen is saved.

State Code This field will display the state the payment was issued from.

Reuse Batch? If a ‘Y’ is entered in this field, the user will have the ability to reuse the same batch

number if preferred.

Check Number This field will display the check number of the check that is being posted.

Process Date This field will need to be left blank and the current date will populate.

Deposit Date This is a required field. Enter either the current system date or the date of the deposit.

Type of Pay

This field will default to the insurance type that represents the insurance company that

issued the check.. The hard code options are:

o MC – Medicare

o MA – Medicaid

o BS – Blue Shield

o BC – Blue Cross

o Co –Commercial

Lock Box Id This is an optional field that can be utilized to enter a lock box id, if applicable

Bank Batch ID This is an option field that can be utilized to enter a bank batch id, if applicable.

User This field will display the user that opened or changed the batch.

Enter all of the necessary information on the ‘Remittance Transfer Options’ screen and ‘Save’.

After the Batch number has been assigned, the follow pop up will appear.

Click on ‘OK’.

Click on the ‘Transfer Records’ tab , or use the <F10>

function key.

At this time the electronic remit will begin the posting process. The user will see

in the help message area.

When the posting process is complete, and if all transactions were sucessfully posted, a help

message stating ‘Records transferred successfully’ will appear in the help message area.

If there were payments and/or adjustments that the program could not post, the user will

immediately see the following pop up. This is a report, 7943 Accounts Not Transferred, that

will need to be printed out. Any payments and/or adjustments that appear on this report will

need to be posted manually.

There is also another report that is associated with the electronic

posting feature. Report number 8082, ‘Paper Remittance Report’. This is a report that prints a

detailed list of accounts, which are part of the check number a user is currently working on,

however; were not able to be included in the electronic transfer. This report will need to be

printed by either clicking on the tab or hitting the F3 function key. The user will then see the

following fields appear on the screen. The Check Number field will automatically populate

the check that is being posted.

.

Click on ‘OK’ and print the report.

Reconciling, Printing and Releasing a batch

Batch Status -

o H = Hold – A batch must be on a hold status before any transactions can be posted.

o E = Release for Editing – In order to print the batch edit report, the user will need to change

the batch status to an ‘E’ and <Save>. Please see below for steps to printing a batch edit report.

o R= Release for Posting – Once a batch has been balanced and the ‘Control Totals’ have been

change, the user will change the batch status to an ‘R’. Note: Clinix will only look for batches

that have the ‘R’ status on them to process in the nightly post. If the batch status is either a ‘H’

or ‘E’ that batch will still be available, to the user, until it is released.

Step by Step on how to print a batch

Change the ‘Batch Status’ to an ‘E’ and <Save>.

Click on the ‘Batch Edit’ tab or use the <Shift F8> function key as shown in the below screen shot.

The printer’ Parameters’ pop up will appear as shown below.

o Printer – The user can either click on down arrow and choose a network printer, or choose to

leave it on the VIEW.

o Updated By – This field will display the User that created the batch.

o Report Type – PDF or CSV. The batch edit report can be printed in either a PDF format or a

CSV. CSV is an excel spreadsheet.

Click on ‘OK’.

This will create the Batch Edit report as shown below. This report can be used to balance the batch or can be

utilized as a hard copy of the transactions that are posted within the batch.

The batch edit report will print in the order that the transactions were posted within that batch.

When payments and/or adjustments are posted in the batch, there will be a summary section for both payments

and adjustments. This summary can be used to balance the days posting.

Step by Step on how to balance and release a batch

Actual Amounts – The dollar amount will automatically continue to calculate as transactions are being

posted in a batch. This is the dollar amount that the user will balance to.

Variance – The dollar amount in the ‘Variance’ field will automatically populate and will be just the

opposite the dollar amount in the ‘Actual Amounts’ field.

Control Totals – This field is for the user to balance the batch in order to release it for the nightly

process. Once the batch has been balanced, the user will enter the amount this is showing in the ‘Actual

Amounts’ field in the ‘Control Totals’ field. As the ‘Control Total’ is manually being entered, the

‘Variance’ field total will change to 0, zero. The ‘Variance’ field must be 0, zero before a batch can be

released for the nightly process.

Batch Status - Once the ‘Variance’ field is 0,zero, the user will change the ‘Batch Status’ field to an ‘R’.

Save

Clinix will check all batches at the time the nightly post/process is run. Any batch that is set to status of ‘R’ will

be processed.

If a batch is on either the status of ‘H’ or ‘E’, Clinix will not process those batches and they will remain in the

database until the user is ready to release them.

Step by Step on how to delete a payment/adjustment from a batch.

From the Batch Control screen, click on the tab or <Ctr g>,

Select #1 – Cal Pay/Adj By Claim

From the ‘Calculate Pay/Adj by Claim screen, enter the check date in the ‘Chk Date’ field.

Enter the account number of the patient that the payment/adjustment needs to be removed. <Enter>

Use the <F8> function key three (3) times until the payment and/or adjustment lines populate in the

‘Payments/Adjustments against a Charge Item’ block.

When the cursor is positioned on the line item that needs to be removed from the batch, click on the

remove record Icon, , or click on the <Ctrl E> on the keyboard.

Save

Repeat the process for any transaction that needs to be removed from the batch.

EXERCISE

(Identify each patient’s account number before starting.)

1.

Patient Name: Bill

Insurance Carrier: United Healthcare

Key Code: 00147

Check Number: 123

Check Date: 1st of the month

DOS: Yesterday

CPT Code: 99203

Charge Amount: $200.00

Allowed Amount: $100.00

Coinsurance Amount: $0.00

Applied to Ded: $0.00

Co-pay Amount: $15.00

Amount Paid: $85.00

Check Number: 123


DOS: Today

CPT Code: 99203






Amount Paid: $85.00

2.

Patient Name: Sherry

Insurance Carrier: Accordia

Key Code: 01026

Check Number: 4560


DOS: Yesterday

CPT Code: 99205



Coinsurance Amount: 20%



Amount Paid: $180.00

Check Number: 4560


DOS: Today

CPT Code: 99205



Coinsurance Amount: 20%



Amount Paid: $180.00

3.

Patient Name: Dan

Insurance Carrier: Medicare

Key Code: 00450

Check Number: 8909


DOS: Today

CPT Code: 99203






Amount Paid: $0.00

Check Number: 8909


DOS: Today

CPT Code: 80050






Amount Paid: $80.00

4.

Patient Name: Ann

Insurance Carrier: Aetna

Key Code: 00051

Check Number: 8787


DOS: Today

CPT Code: 81000






Amount Paid: $44.00

Check Number: 8787


DOS: Today

CPT Code: 99213






Amount Paid: $55.00

5.

Patient Name: Jan

Insurance Carrier: Cigna

Key Code: 00043

Check Number: 2423


DOS: Today

CPT Code: 99221






Amount Paid: $80.00

6. Post a bulk patient payment from Dan for $300.00

QUESTIONS AND ANSWERS

1. How do I get to the screen to perform payment posting by claim from the master

menu?________________________________________________

2. Define the 3 different batch statuses? _____________________________________________________

3. What is the purpose of the Control Totals?

____________________________________________________

4. What are the two Remit reports that you can run? _______________

_____________________________________________________

5. How can I fix a payment record that would not transfer?___________

_____________________________________________________

ClinixPM Training Signoff

NAME ___________________________________

DATE TRAINING COMPLETED _______________

Posting Payments on Account - Module 7

Check mark Subject User’s

Initials

1. Create a Batch

2. Posting Copays

3. Posting a payment from a patient

4. Posting a bulk payment from an insurance carrier

5. Posting a payment by claim with the payment and adjustment

calculated

6. Posting a payment by charge

7. Electronic payment posting

8. Reconciling, Printing, and Releasing a Batch

payment posting on account module 7 - clinixmis.org posting on account-trainee… · posting...

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