Itemizing insurance payments

Being able to accurately estimate how much an insurance company will pay on a procedure is extremely important when you are presenting treatments to a patient and collecting payment after treatment. Itemizing payments by procedure allows you to keep track of what insurance companies have actually paid.

If an insurance company pays 50% on crowns and your normal charge for a crown is $600, the estimated insurance payment is $300. However, when you receive payment, you discover that the insurance company pays a maximum of $250 on the procedure.

When you post the payment, if you select Yes under Update Payment Table, that amount is saved. The next time a patient with that insurance coverage comes in for a crown, the estimate is $250 of coverage instead of $300.

To itemize an insurance payment

1.   Select the patient you want to create an insurance payment for.

2.   In the Accounts transaction log, double-click the insurance claim that you want to enter a payment for. 

The Primary or Secondary Insurance Claim window appears.

 

3.   In the toolbar, click Enter Payment, and then in the menu, click Itemize by Procedure. 

The Insurance Coverage Update dialog box appears.

4.   Type the amount paid.

5.   If the amount paid is different from the estimated amount, select Yes under Update Payment Table, and then click OK.

Each procedure prompts you for an itemized payment, and the Total Insurance Payment dialog box appears.

 

6.   Under Edit Insurance Payment, type the Check # of the insurance payment.

This information appears on deposit slips.

7.   Under Deductible Applied For Claim, type the amount that the Explanation of Benefits (EOB) shows was applied to the patient’s deductible in the appropriate field.

8.   Click OK/Post.