Line Item Accounting Insurance Payments

Use the Receive Insurance Payment window to process insurance payments.

This topic explains the features that are specific to Line Item accounting.

Write-Off Codes

If the claim includes a write off, an insurance write off code must be selected. With Line Item accounting: insurance write-offs are posted when the insurance payment is recorded, not during checkout as with Balance Forward accounting. An adjustment code must already be assigned in order for PracticeWorks to post the write off.

There are two ways a write off code is defined in this window: Predefined, and manual entry.

Pre-Defined

If a code is selected for UCR write-offs in insurance estimating, then it is used for insurance write-offs. The write-off code selection honors the levels of estimating, moving to the next location if a code is not found. The order is:

1 - Employer Plan  2 - Insurance Company  3 - Office-wide Setup

Manual Entry

To enter the write-off code manually:

  1. Click Select write-off to display the Transaction code list, filtered for adjustment codes.

  2. Select an adjustment code. You are prompted to save this as the default write-off code.

  3. Click Yes to save the code to the Employer Plan and use it for this payment. Click No to use it for this payment without saving.

Amount to Apply

The amount of insurance applied to the procedure cannot exceed the Submitted amount minus the Previous IP.

The cumulative total of Amt to apply cannot exceed the Insurance payment amount as displayed in the upper left corner of the window.

Amount to Write Off

The write-off amount cannot exceed the Submitted amount minus the Previous IP.

If the write-off amount is not recorded on the Receive Insurance Payment window, you must add it manually to the ledger, distributing it via the Payment Distribution window.

Distributing Insurance Payments and Write-Offs

When the Amt to apply and Amt to write-off entries are complete, select an OK option for updating the blue book. The insurance payment and write off are recorded on the Ledger, as well as the distributions to the claim procedures.  

 

Related Topics

Ledger Setup

Transition Utility

Patient Ledger

Payment Distribution

Distribution Swaps

Undistributed Payments Expert

Security Events

Reports

Configuration Settings