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From the main invoice screen (below) selecting P-Post payments will initiate posting payments as shown below.
When posting payments your options include:
A-Add (add a payment)
Post Payments - Medicare EOMB (Explanation of Medical Benefits)
Special notes about the three claims listed above: (1) The first claim has a deductible; (2) The second claim has a crossover secondary insurance; (3) The third claim is a rejection -- These three conditions will be described in detail below. Other Special Notes: (1) The patient will receive a statement from Medicare showing their responsibility; (2) if you accept assignment the Medicare Allowed amount is all you can collect; (3) if you did not get the patients signature (prior to transport) that they will be responsible for the bill if Medicare rejects, then you cannot bill the patient.
Post Payments Screen 1--Blank Screen 1
The screen above will be displayed after pressing the A key (A-Add). A blank payment will be displayed in the Add/Edit window as shown. The default date is today's date from the computer system clock. Some overwrite this date to the date on the EOMB, but most often, today's date is used, and this makes bank statements, etc. to agree with the date posted.
Medicare Payment with Deductible
Post Payments Screen 2 - Medicare Payment With Deductible
Per the EOMB above, we have posted the payment of $135.06. From the paycodes in Screen 2 above, this patient has Medicare primary (Paycode: 1F-Medicare Filed), and no secondary coverage (Paycode: 7 -- private pay). The patient will receive statements showing responsibility for the deductible and copay ($133.77). A payment description will help the patient in understanding why they owe $133.77 and hence we add the payment description $100 deductible, $33.77 copay as shown-note that the description field is longer than can be displayed here, but scrolls when you are typing, and the total description does fit on statements. The description is free-form--add anything you so desire, but remember that this description will be printed on statements. Anytime it is obvious that the patient will eventually be responsible for part of the payment, it is a good idea to add a description to the payment, otherwise leave it blank. After posting the money received, next post the contractual writeoff. Note that if you did not accept assignment on this claim, there is no contractual writeoff, and the patient is responsible for the full amount after the Medicare payment. There are many disadvantages to not accepting assignment, and these are covered in another section. Additionally, there is proposed federal legislation to mandate accepting assignment.
Medicare Contractual Writeoff
Post Charges Screen 3 - Medicare Contractual Writeoff First Screen
Note that on Screen 2 above, One of your choices on the bottom prompt line was F2-Writeoff. Pressing the function key F2 will display Screen 3 with data entry line at the bottom as shown. From the EOMB, the Medicare allowed amount is $268.83, and this was entered as shown. Pressing the <ENTER> key to complete the data entry will result in the contractual writeoff being calculated and posted as shown in the next screen.
Post Charges Screen 4 - Medicare Contractual Writeoff Completed
In screen 3 above, the Medicare Allowed amount of $268.83 from the EOMB was entered and when the <ENTER> key was pressed, the contractual writeoff was calculated and posted as shown above. To complete this payment (and contractual writeoff), hole down the Ctrl key and tap the END key (^END-Save), and you will return to the invoice screen (screen 1) from which you initially came. You may note that the F (Filed) automatically changes to P (Paid) in the invoice screen, plus the posting date is also automatically entered into the invoice screen.
Medicare Payment With Crossover Secondary Insurance
The middle claim in the EOMB shown above is for a claim with Medicare Primary, Insurance Secondary. This is noted on the EOMB as CLAIM INFORMATION FORWARDED TO:.......... This is known as a crossover, and your secondary insurance is filed along with your Medicare filing, and Medicare files with the secondary for you. Sometimes Medicare will crossover for you, even though you did not show a secondary payer, e.g. sometimes Medicare is a good source of secondary coverage unknown to you. For example, if your payment screen showed Medicare primary, Private secondary and the EOMB showed crossover, then you need to enter the Medicare payment as described above and then edit the invoice screen to add the secondary insurance, plus enter the secondary date filed as the same date that Medicare was filed (because that is what actually happened). Otherwise, the system will file a paper claim to the secondary when Print Insurance Forms is invoked.
Usually, when Medicare is primary and there is a secondary payer, there is no use in wasting stamps and statements -- the claim will be paid in full. You may choose to put the invoice status to H(old), and this will prevent invoices and statements from being mailed. If there are partial payments and rejections, the invoice status can be changed to A(ctive), and from then on, statements will begin to be printed.
When posting Medicare payments there may be some rejections. You need to go on through the long list of claims on the EOMB, and thus, you have two choices: (1) Accept the rejection and post a zero amount payment-described below, or (2) flag the code field in the invoice screen with RN and come back later to make changes and/or refile paper; the latter being most prevalent. The third claim in the EOMB shown above is for a Medicare rejection (Code PR-50 means rejected ambulance not necessary). To post a zero payment means that you are accepting the rejection, and now the secondary payers are responsible for payment. However, there are some secondary insurance companies that treat a Medicare Primary rejection as an automatic secondary insurance rejection. Thus avoid posting a Medicare rejection if there is a chance of refiling and payment. To post a rejection, enter a zero payment as shown in the following screen
Screen 5 -- Post Medicare Rejection
After entering a zero payment, a prompt line at the bottom will allow entering the reason for rejection. This line will be on the statement, and with the description field printed directly underneath (if not blank). Thus, you can extend your rejection message with the description field, keeping in mind that the description line is a continuation and will follow the reason rejected.
(Change) a Payment
When you have Post Payments Screen 1 above displayed, highlight a payment and press the E key (E-Edit) and the charge will be moved to the add/edit window as shown in Screen1. From here, you can type over the existing payment as required. Note that you should only edit payments that were posted in the current period to satisfy certain accountants and practices. For payments posted in other periods (months) use the MARK function to post reversing entries.
When you have Post Payments Screen 1 above displayed, highlight a payment and hold down the Ctrl (Control) key and tap the U key. Note that you should only delete payments that were posted in the current period to satisfy certain accountants and practices. For payments posted in other periods (months) use the MARK function to post reversing entries.
Mark (correct) a Payment Made in Another Period (Month)
After establishing a months operational data, the month is closed. Thus, changing any of this data will invalidate this data. Pure accounting requires that reversing entries to be made to correct data in past months. If you wanted to delete a payment, you would post an identical payment, but use a negative amount. However, if you filed claims, these two offsetting payments would look suspicious and confusing. If these two offsetting payments are "MARKED" they would show these would not be included on subsequent claims filings, and the overall balance would be correct. It follows that if you wanted to change the amount that you would post a nullifying amount as before, and then post an additional payment in the correct amount. To mark a payment, highlight the payment and press the M (M-Mark) key.