Billing FAQs

How do I make collection fee automatically bill with lab?

You can utilize the Blocked and Substitute feature in OP so that each time the a test such as glucose or hgbA1c is ordered, it will add the collection code. You have the option of setting this up for individual payers or for all payers.

How do I change diagnosis code after note finalized?

You cannot go back and add the diagnosis directly to the note, but you can create an addendum and indicate that you have changed the diagnosis. Since the charges have been posted and submitted, there is no longer a superbill for the visit.

To rebill the claim with a correct ICD code, edit the archived transaction by adding the new ICD on the Basic Info tab associated with appropriate CPT codes and then re-queue the claim. Add a claim note so that you know what has been done.

How do I see all charges for day's visit when in note?

If you are in an encounter, you do not have to close out of the note. Click on the Superbill button that is on the top toolbar, and it will show you what codes have been already added to the visit for a diagnostic test or an immunization. Once a diagnostic test or immunization has been documented the code will automatically be sent to the superbill, so if they are appearing in your summary there will be a charge on the superbill.

Another way to view all the charges for a visit is to go to the Schedule > Tracking and check Billing Reconciliation. From here, highlight the visit and you will see all charges associated with the visit.

On the Coding tab of the visit, you will only see codes that have been added directly to the Coding tab, such as the E&M code or a procedure code. Codes that have been added to the Procedure tab of a template will also appear on the coding tab.

How do I add more than 4 diagnosis codes to a claim?

You are able to add 4 diagnoses per CPT code with a total of 12 per claim. This is per 5010 guidelines. You are able to add as many diagnoses as you want to the note itself.

You also have the option to document and bill for a separate visit with the appropriate codes if you are seeing a patient for a well visit, and providing care for a separate identifiable service.

How do I run my statements?

When an office is ready to send patient statements in bulk batches, they will use the Statement Queue in the Billing Center.

  1. Click on the Billing button on the Smart toolbar.

  1. Click on the Statement Queue tab.

  1. There may be statements already in the Statement Queue. They will remain under this tab until you delete or send/print them, so you can let them accumulate for the whole day, or even until the end of the week, before printing everything all at once. Statements may exist here already if:
  •  While posting payments, you selected the patient action, Create Statement.
  • Or, while in a patient account, you selected to Queue a Statement.
  1. Ensure the Unsent only checkbox is selected.
The Unsent only checkbox needs to be selected in order to create batch billing statements. If you have this box unchecked , you will see the history of all the statements that were previously transmitted. For more information on viewing statements previously sent from the queue, click here

Begin Batch Billing

  1. Click on Bulk Statements button in the Statement Queue. This this will add to the queue a statement for all patients who have not paid past due bills. This makes it easy for the biller to track everyone who needs a statement.

  1. The Batch Billing Statement window opens.

  1. Identify your statement parameters.
  1. Select your transaction date range. You can choose from the following:
  • All dates
  • Date Range            
  1. Balances to include, Insurance and Patient Balance or Patient Balance Only.                                 

  1. (Optional) Select if the user wishes to minimize the printing of excess, un-needed statements by checking off one of all of the Account Claim Options:
  • Include Accounts on Hold? - accounts that are set to Hold (don't send) via the patient insurance tab, next to the selected financial guarantor
  • Exclude Accounts that are Uncollectable? - if a claim is set to a FU-Finalized Uncollectable status from the Claims+AR window or patient account, those claims will be excluded from being generated
  • Exclude Claims Older than a specified date
  • Exclude if all sent > more than 3 times

  1. Select the Last name of the guarantor group that would receive the batch statements. This field only appears if you have selected more than one group in your Statement System Preferences.


  1. The system will default the Medical Home to ALL, allowing you to print statements for patient balances, regardless of the Medical home listed on their Register. You can de-select all and select an Medical Home; the batch will include statements for the specified location ONLY.
  1. The system will default the carrier parameter to ALL, allowing you to print statements for patient balances, regardless of the insurance payer listed on their account. You can de-select all and select an individual payer; the batch will include statements for the specified payer ONLY.

  1. Select the minimum family balance dollar amount. This is the lowest value of a family statement that will print. For example, if you do not want to print statements for families who have balances due of less than 10 dollars, set this field to 10.

  1. Select the days since last printed. This determines which families will receive a statement. For example, if you do not want to send a statement to a family who has gotten one in the past 30 days, enter 30.

Note: If you want to send statements to all families, regardless of when their last statement was sent, enter -1 in this field.
  1. (Optional) Enter a custom message to appear on your statements to add onto your dunning message or replace your dunning message. 
Note: Batch statements are created by the Guarantor Last Name. For more information about batch grouping, see Patient Statements Setup.
  1. Click on the Begin Batch button to generate patients with balances based on criteria set.
  2. A popup window will display the statements that match the criteria you previously identified. Click Yes to continue.    
  3. The system will generate batch statements for all patients matching the criteria identified above. Once the process is complete, the dialog box will close, & you will be taken back to the Statement Queue window.  
Note: If the intention is to create "batches" of statements meeting different criteria and using different custom messages, you can repeat the steps listed above to set new parameters to identify another range/batch of patient statements.
  1. Back in the statement queue, the user will see all statements generated to be printed or sent via electronic statement file.  
  • If mailing statements from your office, select the Print Statements button  and select Yes to print statements.
  • If sending an electronic statement file to the clearinghouse, click  and select Yes to create a file for transmission to the mailing house.
    • A progress window will appear, and when complete, will prompt you to send the file.

How do I put patient in collections for bad debt?

To change a patient's status to In Collection, follow the steps below:

  1. Click the Register button.
  2. Search for the patient.
  3. On the Patient tab, change Status from Active to In Collection.
  4. Click the save button to Save the changes.

How do I post a patient adjustment?

To post a patient adjustment, follow the steps below:

  1. Open the Patient Account.
  2. Click the Payment tab.
  3. Click + Payment.
  4. Change the payment method to Adjustment Only.
  5. Enter the adjustment amount in the adjustment column for the appropriate procedure code.

How do I post patient balances and credits to OP from old system?

To post patient balances to OP from old EMR system, follow the steps below:

  1. Open the Patient Account.
  2. Click the Charges Tab.
  3. Click + Claim.
  4. In the Add/Edit Charges window, clear the patient's coverage by clicking SP.
  5. Enter the provider and diagnosis.
  6. Enter the balance forward CPT, BEGBAL, and the amount of the patient's balance to be moved to OP.
  7. Click Save.  If you click Save + Queue, the claim will be added to the transmit queue.

To post patient credits to OP from old EMR system, follow the steps below:

  1. Open the Patient Account.
  2. Click the Credits Tab.
  3. Click + Credit
  4. Select Payment Method: Transfer (this will prevent the credit from looking like new revenue)
  5. Enter in the amount for credit.
  6. Click Save.

Can I daysheet if I am not done with charges from day before?

Yes, you can daysheet even if you are not done with charges from previous day. The importance of running a daysheet is to lock in the payments and prevent them from being deleted. If a payment is deleted/voided prior to posting the daysheet, it will not show in the audit log, reports, or the Patient's Account. As for charges, you are able to run reports based on the DOS, therefore you will still be able to filter for them regardless of what daysheet(s) they were posted on.

How do I align HCFA form?

Important Reminder for cloud clients:

  • When the print settings page appears on the screen, select Actual Size and not Shrink to Fit or Fit to Width.

How do I complete Patient Portal payments?


Integrating with Instamed Merchant Services for payment processing services allows for payments to be made securely, simply, and conveniently. Credit cards can be saved on file directly in OP and payments can be taken through the Patient Portal.

Posting Credit Card Payments

  1. Click the Schedule  button to open the Schedule and Practice Workflow window.
  2. On the Calendar locate and double-click on the patient's appointment. The Add/Edit Appointment form will open.
  3. In the Add/Edit Appointment form, click the Copay  button. The Patient Credit Account window will open.  

  1. Select Credit card (present) in the Pay method dropdown.
  2. Swipe the patient's credit card. The Account Holder's Info. will appear on the screen.
  3. Enter in the payment amount in the Patient field.
  4. (Optional) Click the Save on File option to save the credit card securely on that individual patient's account.
  5. Click the Save/Post button.
  6. Click the Save/Post button, a status bar will appear as the transaction is processed through Instamed.
  7. A popup window will display the message that the transaction was either approved or denied.
  8. If the transaction is approved, another popup message will ask if you would like to print a receipt.

Credit card payments that are not processed at the Front Desk can be entered through the Patient Account in the Credits Tab.

Reprinting a Credit Card Transaction Receipt

  1. Click the Accountbutton.
  2. Click on the Credit  tab.
  3. Click the Plus Credit   button.
  4. Click on the Ledgertab.
  5. Click to highlight the transaction.
  6. Click the Reprint button at the bottom.

Keeping a Credit Card on File if Contracted for Credit Card Services

  1. Click the Account button.
  2. Click on the Credits tab.
  3. Click on the Plus Credit  button.
  4. Swipe Credit Card.
  5. Once Credit Card information is populated into Office Practicum, click Save on File  button.

Using Auto-Pay with Credit Card on File

Users are able to use a patient's credit card that has been saved on file when insurance payers assess patient responsibility on an EOB.

  1. Click on Activitiesalong the Menu bar.
  2. Click Post Bulk Payments  option in the dropdown.
  3. Indicate the Patient reason of 1 - Deductible, 2 - Coinsurance, or 3 - Copay.
  4. In the Patient Action column, click on the dropdown to select a patient action Autopay PC+CC or Autopay CC only .

Removing Saved Credit Card on File from Patient Account

  1. Click on the Patient Account button in the Smart Toolbar.
  2. Click on the red minus Deletebutton, in the Overview tab - Demographics/Patient Responsibility section to remove the Credit Card info.

Keeping a Credit Card on File if not Contracted for Credit Card Services

For HIPAA purposes, this can not be stored securely in OP.

Why are my CC Payments Showing up as PC?

When using Instamed Merchant for Credit Card Payments, if there is more than one transaction, the first transaction will show up as CC Payment, and the other transactions will show up as PC. You need to balance in Current Payment tab in the Billing Center. 

Processing Credit Card Refunds in OP if Using Instamed Merchant Services

It is an option to do a credit card refund the next business day after the transaction was originally processed.

  1. Open the Patient Account by clicking on the  button.
  2. Click on the Credits   tab.
  3. Click on the Refund  button.
  4. Indicate in Refund Method how you are removing this credit from the account of the patient (Check, Credit Card, Etc.).
If selecting the 'Refund credit card' Refund method, then you will need to have the credit card information available for entry.
  1. Indicate how much from the patient credit account is being removed.
  2. Construct a note indicating why this refund is being performed (optional).
  3. Click Save/Post.

Voiding Credit Card Transaction in OP if using Instamed Merchant Services

When credit card transactions need to be voided the same day that they were processed, follow the steps below:

  1. Open the Patient Account by clicking on thebutton.
  2. Click on the Credits   tab.
  3. Click on the +Credit  button.
  4. Click on the Ledger  tab.
  5. Click to highlight the desired transaction.
  6. Click the Void button to refund the transaction. A popup window will appear if you wish to Void the transaction, select 'Yes' or 'No'.
  7. Print Receipt that pops up as a print preview.
  8. Close window with the Red X in the upper right corner.

Credit Card Payments via Patient Portal using Instamed Merchant Services

Note: Patients are able to make payments via OP Patient Portal. Practices will be able to process the payment reports (DPA files) from Instamed into OP. DPA payment files can be brought into Office Practicum the next business day.
  1. Click on the Billing Center  button.
  2. Click on Claims + A/R tab.
  3. Click on Fetch and then Process buttons. 
  4. Payments from the DPA file would auto apply to the newest balance on the patient's account.
  5. Click on the Current Receipts tab.
  6. Filter the Deposit Source column by Portal.
Note: Users can log into the Instamed site throughout the day to see what is being paid by patients.

Balancing Payments from DPA files 

The balancing or allocating of DPA files is recommended to be done before running a daysheet so that payments can be confirmed in the Current Receipts tab of the Billing Center. When reviewing credit card payments in the OP software, those with an Auth Code have been successfully transmitted to InstaMed. Therefore, you can safely assume the payment is underway.

  1. Click on the Current Receipts tab .
  2. Confirm the credit card payments listed against Instamed's End of Day (EOD) report engine daily.

To access Instamed's EOD Report:

  1. Log into your Instamed Portal using your login credentials.
  2. Select the Payment tab.
  3. Select the Payment History tab.
  4. Select EOD (end of Day Summary).
  5. In the Date tab, select the date for which you would like to balance.
  6. In the Users tab, select the users for which you would like to view or leave blank.
  7. Select the desired Outlet option or leave blank to see all Instamed payments across your Instamed account.
  8. Click Search.
Note: Users can log into the Instamed site throughout the day to see what is being paid by patients.

Note: If you have questions about a certain payment or if something in InstaMed does not match with OP, it may be best to contact Instamed.  They can see each payment and authorization/denial codes related to them. In addition, they have the ability to see if a payment was deposited into your bank account or when it is scheduled to be deposited.

How do I correct charges if I clicked cancel while posting and now charges show as posted?

To correct current charges, follow the steps below:

  1. Open the Patient's Account.
  2. Click on the Charges tab and look at the lower half of the window (Current Posted Charges/Payments) Note: Charges tab = charges that have not yet been daysheeted.
  3. Click the charge line.
  4. Click the edit pencil, and make desired edit.
  5. Click Save or Save + Queue.

If I void payment taken at front desk and applied during charge entry, where does the money go?

If a payment is voided prior to daysheeting then it is deleted from OP. There is no record of the payment as it will not be reflected in the audit log or in the patient's account.

If a payment is voided after it was posted on a daysheet then the money will be moved to the credits tab. All actions will be listed in the audit log, on reports, and on the patients claim history.

How do I adjust off a balance at same time as posting copay in charge window?

To adjust off a patient balance while in the payment window, click in the adjustment field and enter the amount to be adjusted. 

Note: You will also need to enter your adjustment reason at this time.

How do I post an ERA that has payments that belong to OP and to legacy system?

Often, after you Go-Live with OP 14, you will receive ERAs that contain claim payments for claims in OP and claims that are in your former system.  It should be noted that only the payments that belong to OP claims can be posted in OP.  This means that it will appear that your ERA does not balance.  To note the ERA line accordingly:

  1. Click the Billing button and select the ERA Payments tab.
  2. Expand the appropriate Payer and locate the Check that appears unbalanced.
  3. In the Note column, make a notation for yourself.  For example, if the ERA is for $200.00, but only $150 can be posted in OP, then note "Posted $150.00, other $50.00 belongs to legacy system (date + initials or Stamp)".
  4. Post the legacy system payment in that system using the same ERA Check/Payment ID in OP.  That way, you will easily be able to identify the payment.  

What do my claim status categories mean?

The claim categories group your claims according to the last claim phase the claim went through. For example, after your claim has been transmitted, it will have a Q2 category, indicating "Transmitted."

Note: The categories rarely have to be manually changed.

The other category changes occur when either an OP user makes a change with the claim, or a response is received from the clearinghouse or payer. For example, if a claim is transmitted, it will be a Q2 category and then when the clearinghouse has accepted the claim and forwarded it to the payer, the category will automatically change from a Q2 to an A1, indicating "Accepted for Adjudication."

To learn more about how the claim status categories are defined, click here.

How do I move a payment posted to the wrong account?

When a payment has been posted to an incorrect account, you'll first want to determine if the payment has been archived.  Archived transactions (or ones that appear on a daysheet) appear in black text, while current transactions appear in blue text.  The steps below are also determined by the source of the payment (Patient or Insurance).

Correcting a Current Payment Posting (Patient or Insurance) 

  1. Click the Account button.
  2. Navigate to the account that has the incorrect posting.
  3. Click the Claims tab.
  4. Expand the date of service to see the payment posting.
  5. Highlight the payment (and associated adjustment and patient responsibility if applicable).
  6. Click the Void button located at the top of the window.
  7. Navigate to the correct Account, and post the payment as you normally would.

Correcting an Archived Patient Payment Posting

  1. Click the Account button.
  2. Navigate to the account that has the incorrect posting.
  3. Click the Claims tab.
  4. Void the incorrectly posted payment (this will create a credit on the patient's account) and adjustment.
  5. Click the Credits tab.
  6. Click the +Refund button.
  7. Select Refund Method: Refund Transfer.
  8. Enter the amount being moved from the Patient.
  9. Enter a Note if desired.
  10. Click the Save / Post button.
  11. Navigate to the account where the money belongs.
  12. Click on the Credits tab.
  13. Click the +Credit button.
  14. Select Pay Method: Transfer General.
  15. Enter the amount being credited to the account.
  16. Enter a Note if desired.
  17. Click the Save / Post button.

Correcting an Archived Insurance Payment Posting

Follow the 12 steps above.  Then, perform the following:

  1. Select Pay Method: Insurance Transfer.
  2. In the Debit Patient field, search for and select the patient who currently holds the credit.
  3. Enter the transfer amount to the right of the patient's name.
  4. Enter a Note (if desired).
  5. Click the Save / Post button.

How can I mark stuck Acknowledgment files as reviewed?

In the event you are getting an ISC error while Processing Acknowledgement files, you will want to follow these steps to mark files reviewed:

  1. Navigate to Activities > Administrative Documents.
  2. Select Transaction type 277.
  3. Click the Search button.  All outstanding files will display with the stuck file at the top of the list.
  4. Select the Revd? checkbox for the file to mark it as reviewed.
  5. Click the Mark Reviewed button.  
  6. Click the Billing button.
  7. Click the Claims + A/R tab.
  8. Click the Process button.
  9. Repeat this process until all files that have not been reviewed have been marked reviewed.
Note: This error may also occur when Instamed portal payments are made but the patient account number was incorrectly entered.  Users will want to be certain to visit their Instamed account to review patient payments and enter them manually into OP if the account number was incorrectly entered. To review the files in OP:
  1. Navigate to Activities > Administrative Documents.
  2. Select the Correspondent ID IMD and Transaction type PAY.
  3. Follow the above remaining steps.

Why won't the insurance rank?

If you are unable to rank an insurance entry, it is likely that there is a space in the Subscriber ID number or Group Number.  To remove the space, simply locate the space and use the backspace function on your keyboard to remove it.  

Note: If a claim has already been submitted under the ID or Group Number with the space, OP 14 will not allow you to make any edits to that insurance record.  You will need to recreate the insurance without the space and rank the new entry. 

Why is the same insurance showing as Primary and Secondary?

If you have one insurance entry, but that insurance is showing as Primary and Secondary, then it is likely the the ranking was not cleared prior to switching the ranking. To avoid this, be sure to click the C in the ranking field to clear the existing ranking before selecting P for primary or S for Secondary.

Where does the CLIA number pull from?

CLIA numbers are often required to appear on claims where labs are being billed.  Where the CLIA number pulls from depends on how the claim is being submitted.  

  • For electronic claims (837): the CLIA number is pulled from the CLIA ID field located under Utilities > Manage Practice > Practices/Locations and appears in box 23.  You will not see the CLIA number in the Add/Edit charges window, but it will transmit electronically on the claim.
  • For paper claims (CMS-1500): the CLIA number must be manually added to the claim in box 23.
  1. In the Add/Edit charges window or the Edit Archived Claim Transactions window, navigate to the Other Items (1-27) tab.
  2. Enter the CLIA number in the Item 23: Referral # field.
  3. Click the Save button.
  4. Print the claim.
Note: Box 23 is the most typical placement of this information.  Depending upon the state in which you are billing, it may be required to record the CLIA number elsewhere on paper claims.

How can I make sure patients are included in my batch statements?

Path: Smart Toolbar > Billing button > Statement Queue tab > Bulk Statements button

Here are a few of the batch statement parameters you can check to ensure that your patients are included in your statement batches.

  • When batching your statements, ensure that Exclude if all sent >= XX times is deselected or the number in the field is high enough to not effect the batching.
  • Make sure the Minimum family balance is set appropriately. 
Example: If the minimum family balance is set to $20, and the family's balance is only $10, then that family will be excluded from the statement batch.
  • Make sure the Days since last printed is set appropriately.
Example: If all patients should receive a statement regardless of when a previous statement was sent, enter -1.

Additionally, you will want to ensure that all patients have a Guarantor and Statement Method selected at the top of the Insurance tab in their Account or Register. To do this: 

  1. Navigate to the Patient Register: (Path: Smart Toolbar > Register button).
  2. Select the Insurance tab.
  3. Make sure that all patients have a Guarantor and Statement Method selected.

For more information on creating batch statements, click here.

How Can I Set Up a Payment Plan in OP?

Currently, OP 14 does not have a platform for creating or maintaining payment plans. Until a feature for this has been developed, practices may track patients they have put on a payment plan by editing the patients' statuses and making notes on the respective patient accounts. For more information on patient statuses, click here.

How can I view the Current Receipts by specific data?

If you want to change the view of the Current Receipts report, click a link below for further instruction.

How do I reprint a daysheet?

To reprint a daysheet, you will find it easiest to navigate to the Administrative Documents housed within OP 14.

  1. Navigate Activities > Administrative Documents in the main menu. The Repository for Practice Administration Documents appears.
  2. Select Transaction type: Daysheet.
  3. Optional: Enter a Begin and End Date range. This date will be the date that the daysheet was actually processed. It will not be the date of the transactions contained in the daysheet.
  4. Click the Search button. A list of processed daysheets will display. You may click the Date column header to re-sort the data in ascending or descending order to simply locate the daysheet that you are seeking.
  5. Click the document icon to the left of the Document Name to view and/or print the desired daysheet. 

How do I bill under a Provider's Medicaid Assigned ID?

Medicaid insurances (and sometimes non-Medicaid insurances) commonly require the assigned Provider numbers to appear on claims. The placement of this number depends on the requirements for the state in which you are billing. To reflect that information in the OP software and ensure the payer-assigned ID number appears in the correct location, follow these steps:

  1. Add the Provider's payer-assigned ID number to the Insurance Carrier Provider Information window.
  1. Click Utilities > Manage Practice > Insurance Payers. The Insurance Payers List will open.
  2. Expand the insurance who requires a payer-assigned ID number to be submitted on claims.
  3. Double-click the credentialed provider listed below the payer. The Insurance Carrier Provider Information window will open. For more information on adding credentialed providers to insurances, click here.
  4. Enter the payer-assigned ID number in either the Line 24J ID Number field or the Line 33B ID Number field. The ID type and Entity type should also be populated according to the type of number that has been entered in the ID number field.

  1. Click Save.
  1. Set the Rendering or Billing Loop for the Insurance Carrier. The Loop will depend on where the Insurance Payer requires the payer-assigned number to appear on claims.
  1. If you have closed the Insurance Payers List, navigate back to it by clicking Utilities > Manage Practice > Insurance Payers.
  2. Select the payer that requires the assigned number.
  3. Click the Edit Record button. The Insurance Payer Details window will open.
  4. Click the Claims/Routing tab.
  5. Set the Billing loop (Line 33B) or Render loop (Line 24J) to Provider NPI + payer assigned.

  1. Click Save.

Why don't I see all of the CPT code charges that were in the visit's Coding tab?

Only one instance of each CPT code passes from the visit's Coding tab to the electronic superbill. This rule applies whether or not a CPT code was pulled in from an applied template and whether or not there is a modifier present on the second (or third etc.) code instance. 

However, units of a CPT code may be changed on the Coding tab of a visit and will pass to the electronic superbill.

For example, if a provider adds the following CPT codes in the Coding tab (in this order): 99213, 94640, 94640-76, A7003, the only charges that will appear on the electronic superbill will be: 99213, 94640-76, and A7003. Please note, when a CPT code is entered twice, the most recent duplicate code entry (or second instance added) will be the one passed to the superbill.

What do the codes for payment methods mean?

Payment methods are codes used to indicate how a payment was managed. The codes and definitions are found in Utilities > Manage Codes > Coded Values. The Coded Values table will open. Scroll to locate the payment lists and definitions of:

  • Payment Method

  • Credit Payment Method

How do I suppress a Rendering Provider's NPI from a claim?

To suppress a Rendering Provider's NPI from claims for a specific payer:

  1. Go to Utilities > Manage Practice > Insurance Payers.
  2. Select the Insurance Payer.
  3. Click the Edit button. The Insurance Payer Details window opens.
  4. Click the Claims/Routing tab.
  5. In the Rendering Loop field, use the dropdown to select Suppress (don't include). The Rendering Provider's NPI will be suppressed from all claims for this payer.
  6. Click Save.