Advanced Ledger - Balance Forward

This document will explain how to enter a balance forward for your patients. This is generally only used when transferring to MacPractice from a different management software. Entering insurance balance forwards will also be covered, though MacPractice strongly recommends that only patient balances be transferred during a conversion. All Insurance Balances should be closed out before moving them into MacPractice, to keep the integrity of the claim intact.

Configuring the Fee Schedule

To create a balance forward you will need to go to the References ability, and select Fee Schedules in the sidebar. You can create a new Fee Schedule or use the Fee Schedule you have already created for your office. With the Fee Schedule selected, create a new code called "BF," or a non-CPT numerical code, like "999". MacPractice recommends using a code that is simple and easy to remember since you may be using this code many times. When you create your code, leave the Unit Fee set to $0.00. When finished, your code should look something like the picture below.


Check the Patient Responsible checkbox to prevent this code from accidentally appearing on insurance claims.

Entering a Patient Balance

When you go into the Patient ability to start entering balance forwards, you will need to decide if you want the balance forward to show as production or not. Regardless of which option you choose, you will start by posting a charge to the patient's ledger.

If you wish to have the balance forward count as production, enter the amount of the patient's balance from your other software in the Unit Fee field.


With the Unit Fee entered, save your charge by clicking the Save button to the bottom right. This will add a line item on your ledger with the name and description of your balance forward. The Unit Fee will be added to the Balance column and the Patient Portion in your ledger, allowing you to collect this amount from your patient. You can also now start using MacPractice to track the patient's ledger activity.

If your office does not wish to have the balance forwards show as production, leave the Unit Fee as 0.00 in the new charge window, and save the charge. Then, select your balance forward code, go to the Other pop-up menu and select New Positive Adjustment.

With the Positive Adjustment window open, you will need to enter the patient's balance and specify an Adjustment Type. The Adjustment Type allows you to view and track all your balance forward adjustments together in reports. This can be manually entered on the fly, or if you have already entered some Adjustment Types, select the one you wish to use from the pop-up menu.


With the Positive Adjustment entered and saved, a line item will be added to your ledger associated to the Balance Forward. This process will add the patient's balance to the ledger and your Accounts Receivable, however the amount will not be added to your production totals.

For more information on a positive adjustment please review the documentation on Positive Adjustments. <\p>

Entering an Insurance Balance and Applying an Insurance Payment

MacPractice strongly recommends that only patient balances be transferred during a conversion. All insurance balances should be closed out before moving them into MacPractice, to keep the integrity of the claim intact. Plus, if the claim needs to be resubmitted, all claim information will be present in the other software. If you wish to enter an insurance balance into MacPractice from the other software follow the instructions below.

Entering an Insurance Balance Forward
First, enter the balance forward as you would if it were a patient balance forward.

Then, select your code, go to the Print pop-up menu and choose Create Insurance Claim. This will open a claim window where you will need to select a claim form. MacPractice recommends using paper claim so you do not accidentally submit the claim to the payer. You can then cancel the print, or shred the resulting paper claim. Creating a claim will move the balance amount into the insurance portion area to await an insurance payment. If the balance does not move to the insurance portion, please see our Insurance/Patient Portion Troubleshooting Guide with Insurance Estimating, or Without Insurance Estimating.

Note: If you need to resend your claim to insurance it will need to be sent from your previous software. If you wish MacPractice to send the claims out again you will need to recreate ALL charges associated to the original claim. MacPractice strongly recommends not doing this. It may cause confusion with the insurance company, preventing your office from getting paid.

Posting an Insurance Payment to a Balance Forward
You can post an insurance payment to a claim on a balance forward just like you would for a normal insurance payment. Click here for more information on posting insurance payments.

You may also find it useful to enter a New Comment, to clarify the ledger activities.

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