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Entering Insurance Payments Manually (article)

Summary:

In PIMSY, there is a process for manually posting payments. Perhaps you have received payments directly from an insurance company or you have a single EOB sent in the mail or for whatever reason, you need to either enter the payments one at a time or in batches.

Instructions:

In the Invoicing screen, Filter for the Client and Date of Service for which the payment was received.

Check the box for Payment Received in the bottom window.

  1. Enter the Amount the Payer paid on the appropriate line. Make sure this is posted on the correct line (insurance payment on insurance line, client payment on the co-pay/deductible/self-pay etc.).
  2. Enter amount written off according to the EOB.
  3. Pull down the Payer Control # by right-clicking on the column headers to access the column chooser. Locate the number that identifies the claim on the EOB. Enter this number in the box in PIMSY. It will be necessary if you ever need to file a re-submission.
  4. Enter the EOB Date.
  5. Click Save.
  6. Check the EOB for any patient responsibility. In the bottom portion of the Invoicing screen, if any payments were taken at the time of service, there will be another line reflected here. It will either be under Co-pay, or Deductible or Co-Insurance. If there is not, click Copy on the insurance line.
  7. Change the Insurance Payer on the second line to the appropriate self-pay type (co-pay, deductible, co-insurance.
  8. Check the Invoice box, and in the Amount Invoiced field, invoice for the amount of the patient responsibility. This will now show up on the client’s statement, as well as provide a place to post the client’s payment when payment is made. Click Save.

If everything else looks good you are finished.

Batch Posting

From the Invoicing window, click on Batch Posting.

From the EDE window, click on Create New Batch.

PIMSY will ask the following questions:

When you have finished answering the questions, the Manual Batch Posting window will appear. Notice the answers to your questions have already been populated in this window.

Fill in the appropriate information. Be sure to use the TAB key to move to each field. The manual entries will mostly be Inv #, Payer Claim Control # and Amount Paid.

If you have balanced the transaction, the following window will appear:

If there are funds not accounted for, PIMSY provides an easy way to bill the client for the Remainder.

The Save Batch Info button is for stopping the posting(s) and returning to them later. If you are clicking Save and Next for more than one payment, you don’t need to Save each time.

Use Case:

ABC Therapeutics has a client, Kelly Clark, who has seen a provider for an hour session (90837). Kelly has a $25 copay, so Marcia collects the copay and sends an invoice to the insurance company for the remainder. Marcia receives a check in the mail from the insurance company for the balance due on Kelly’s account and enters the payment manually. In the past, Marcia has also entered batches of payments manually from an EOB. PIMSY will track the totals in the bottom right corner to make sure the proper amounts are there for Marcia’s use.

Related Articles:

If you cannot find what you need in this article, please contact Support (email) or call 877.334.8512 ext. 3.

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