Entering an Insurance Payment from the Patient Account

Version 14.10
Path: Smart Toolbar > Account button


Learn how to post payments from the Patient Account.

When you are ready to proceed with EOB posting from a paper EOB, please follow the steps below.

  1. On the OP toolbar click the Patient Account  button.
Keyboard Shortcut
You may also use the F12 key on your keyboard to access the Patient's Account.
  1. Search for the patient in the search box.

  1. Click Payment button.
  2. Click the Plus Payment   button.
  3. The "Add Payments & Adjustments" window will open.
  4. When posting EOBs, work your way from the top of the screen down to the bottom.
  • The date is the date that defaults to the current date of adding in a new payment. 
  • The payment method is the method of payment that the payer is sending back to you. You may use the dropdown arrow to select a different method of payment, such as EFT, Credit Card, etc.
  • The Check/Ref# will be the payment identification or reference number that you want to add to balance your payments at the end of the day.
  • The "M" will memorize the check number that is entered.
  • The "Ck" will reuse the last memorized check number.
  • The Memo field is an optional field. This Memo field is used in offices to identify a specific remark on an EOB. (example: patient's responsibility is applied to deductible and copayment, or Coordination of Benefits update). This Memo Field will appear on the patient's individual claim in which you are posting payment to. It will not appear on an correspondence sent to the patient.
  • The amount field will populate as you add payments into the payment fields.
Note: Some insurance payers have issued credit card payments to providers, if this is a situation for your office, please select the payment method of credit card, and input the details on the right side of the screen.
  • To the far right of your screen, there are insurance details from the patient's insurance record(s).
  • If you are posting a payment and there is a patient responsibility as you're posting, you have the ability to create a statement for the patient after your save your insurance payment. There is the ability to select a statement type. You may select a statement to print of any outstanding Insurance and Patient responsibility, or just strictly Patient responsibility only.
  • There is a note field to view a claim note on the claim that you are ready to post against.
  • If your office would like to create a follow up task for the billing office to follow up on a claim at a later date, click on the Task buttonThe Task button can be used to create claim follow up reminders for today or a future date.
  1. As you move to the lower half of your screen, this is where you will begin to post insurance payments under the Adjudication Details fields.

  1. Looking at the payment grid, the lines are double stacked. Please Note: Claims are grouped together by OP claim number, then charges are displayed below the claim. Click the Plus Sign or Minus Sign  to hide or show claims you are not working on.

  1. As you begin to post your payments into Office Practicum, you will need to record the Payment Amount, Allowed Amount, Patient Responsibility, and Insurance Adjustments under the Adjudication Details.

  1. Working off of your Explanation of Benefits, you will input the allowed amount into the field designated for the "Allows" from the insurance. If a contract has been set up in OP, and the Allowed amount matches the EOB allowed amount, click the green checkmark to the left of the allowed amount field.

  1. Once you have clicked on the green checkmark, your payment amount field will populate with the appropriate insurance write off.

  1. If there is not an allowed amount pre-populated in the allowed amount field (or the amount differs from what populates), you will need to manually enter in the allowed amount from your payer and press Enter on your keyboard.

  1. If the insurance has determined a total charge amount to be the patient's responsibility, click the patient checkbox.

  1. OP will then calculate the Adjustment amount based on the amount in the Allows field and that in the patient responsibility field. In the example below, the $10 copay has been entered and noted as a copayment. You can use the dropdown to select the appropriate Patient Adjust Reason. 

  1. Next, select a Patient Action. If no reason is selected, a default of Hold on Account will be understood and the balance will remain until statements are generated. 

  • The Patient Action options are as follows:
  • Hold on Account: the balance will be held until statements are generated.
  • Create a Statement: a statement will automatically be sent to the Statement Queue.
  • Autopay with PC: the balance will automatically be paid with the patient credit.
  • Autopay with PC + CC (Instamed Merchant Services Only): the balance will be paid with a combination of patient credit and the credit card saved on file (only visible if a credit card is saved on file).
  • Autopay with CC (Instamed Merchant Services Only): the balance will be paid with the credit card saved on file (only visible if a credit card is saved on file).
  1. Once you have all of your adjudication details posted, click Save + Close at the bottom of the window.