Scroll

Payment Window - Financial Charge Information

 Screen_Shot_2017-04-24_at_9.40.06_AM.png

Procedure Fee
This will list the full cost of the procedures, regardless of any payments applied to them. This should match the amounts that were on the claims and in the new charge window. 

Patient Portion
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. 

Insurance Portion
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.

Allowed
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. 

Save Allowed
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.
Screen_Shot_2017-12-28_at_2.19.16_PM.png

Save as Flat Rate
When using insurance plans, this allows you to save the charge's payment amount as the flat rate amount.  

Write-Off
This is the amount that will not be charged to the patient. Usually the write-off is based on a contractual obligation with the insurance carrier.

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. 

Payment
This is the amount that is actually being paid toward each charge. MacPractice recommends entering specific amounts per procedure instead of using the Apply to All button. 

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. 

Appeal Payment
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. 
appeal.gif

Appealed claims display in the Claim Manager for further action by the office. 

Negative Adjustment

 

Unpaid

 

Date Applied

 

 

 

 

 

 

 

Was this article helpful?
0 out of 0 found this helpful
Have more questions? Submit a request

Comments