This article breaks down the meaning of each column in the payment window view. Keep in mind that these columns can be re-ordered, so the order may not reflect YOUR payment window.
This column will display on patient payments only, listing the patient's balance for this procedure. If insurance estimating is used, it will show the estimate. Otherwise, it will display 0 until the insurance payment is entered and the claim is closed.
If you use the Apply buttons, the Apply to Patient Portion Only checkbox will split the payment and only put the amount in this column toward each charge.
This column will display on insurance payments only, listing the insurance's balance for this procedure. If insurance estimating is used, it will show the estimate. Otherwise, it will display 100% of the fee until the insurance payment is entered and the claim is closed.
When entering the payment, you can enter more than the insurance portion, but only up to the amount of the fee and not counting any other insurance payments.
This is the amount that the insurance carrier says is the usual customary and reasonable price. This information is typically found on the EOB but you may set the information in advance if you know it.
This will pull in the amount listed on the Plan tab of the Insurance Company Reference. If there is no amount entered on the reference, then MacPractice will assume that the full amount is allowed. It can be edited as you enter the payments.
If plans are not used, then this box will always be empty. Manually type in the amount from the payment.
The "Save Allowed" checkbox is used to update the patient's insurance plan procedure amounts when you edit an allowed amount for a given procedure. When using insurance plans, it will take the new allowed amount and update the procedure's allowed amount in the insurance plan. Adjusting the allowed amount will automatically check Save Allowed.
If the patient is not associated to a particular insurance plan, the Save Allowed checkbox will be greyed out.
Save Allowed will not be checked if you choose to click "Appeal" on the "Would you like to appeal the amount paid for this charge" prompt.
Save as Flat Rate
When using insurance plans, this allows you to save the charge's payment amount as the flat rate amount.
Enable the Preference > Ledger > Payments > Insurance Payments "Auto calculate the write off when the provider participates with the carrier" to have this number fill in on it's own. The amount will auto-calculate to be the difference between the procedure fee and the allowed amount. [Office Fee] - [Insurance Allowed] = [Write-off]
In MacPractice, write-offs will only display on the insurance payment and are intended for use with insurance only. Any other amounts that need zeroed out or discounted are entered in as negative adjustments.
You may only enter in a payment amount that is less than the full fee amount. If an insurance payment has already been applied, then you can only enter in the amount remaining.
If insurance appeals are turned on in the ledger preferences, then this box will be enabled. It will automatically check when the allowed amount that pulls from the insurance plan is overridden in the payment to a lower amount.
Appealed claims display in the Claim Manager for further action by the office.
The Negative Adjustment column allows you to apply a negative adjustment to this particular charge. This column only displays when posting or editing an Insurance Payment. Negative Adjustments previously posted to this charge are not necessarily reflected in this column, so you'll need to be sure to select the charge in the ledger to determine if a negative adjustment has been posted prior to adjusting directly from the payment window.
The Unpaid column displays the amount of the charge that has not been addressed by a patient or insurance payment, and has not been adjusted via a positive or negative adjustment.
This column tracks the last date that a payment was applied or changed for the given charge. This impacts both patient and insurance payments, but will always track the most recent date that the applied amounts were touched upon for this specific charge.