Use the Post Insurance Payments (pip) program to manually post insurance payments and adjustments that could not be posted automatically using autopip.
- 1 Get Started Posting Payments and Adjustments
- 2 Post Insurance Payments by Claim ID #, PCC #, Name, and More
- 3 Insurance Charge Selection (Screen Reference)
- 4 Payment and Adjustment (Screen Reference)
Get Started Posting Payments and Adjustments
How do you post insurance payment and adjustments in
Read the Post Insurance Payments tutorial to review all the steps.
Read the sections below for helpful references on each screen and step in the process.
Post Insurance Payments by Claim ID #, PCC #, Name, and More
The first step to manually post a payment is to find the patient or claim for which you have received an EOB.
Since names can change and carriers sometimes return payment with a parent’s name, Partner has lots of different ways to find the correct patient and charge entries.
Search by Claim ID#: By default, pip asks for a claim ID number. Every time Partner generates a claim, it creates a unique claim identifier number. This number appears in
oopsand on various billing reports. PCC can help you configure outgoing claims so that the unique claim identifier is on every claim. Most insurance carriers will then return that number on the EOB.
Search by Patient Name: Press Enter or F2 – Find Patient to search for a name or part of a name and pick from a list of results.
Search By Patient ID#: Every patient and account in Partner has a unique account number. You can find this number in the upper right hand corner of the Family and Patient Editors (
notjane). PCC can help you configure your outgoing claims so this number is included with the claim. Many insurance carriers will then list that unique number on the EOB.
When you receive an EOB with the patient ID#, enter the following on the
pippatient search screen:
Search by Account Name, Insurance ID#, Phone Number, Other: The advanced find routines in Partner can help you find a patient by a wide range of criteria. After running pip, press F2 – Find Patient, and then press F4 – Advanced Search. Then select a search criteria on the “Find’em” screen. You can enter an asterisk (*) to see a list of available search criteria:
Insurance Charge Selection (Screen Reference)
Once you find a patient or claim,
pip displays a list of unpaid insurance charges for the patient.
The Charge Selection screen shows the date, provider, procedure code, procedure name, primary diagnosis name, amount charged, and amount due for every outstanding charge with some amount pending an insurance company.
Use the Page Up or Page Down keys if there are more outstanding charges than can fit on one screen. The oldest charges will be sorted to the top of the screen for easy selection.
Selecting Charges for Payment: When you wish to post payments and adjustments, enter item numbers for the appropriate charges. When selecting charges, you can enter more than one number. Separate item numbers by spaces or commas, or use ranges, such as “1-4”. Once you’ve indicated the items to be paid, press Enter and you will see the Payment and Adjustment Screen.
Find Missing Insurance Charges
The Charge Selection screen shows only pending charges on the patient’s current guarantor account. If you are missing a charge that you expected to see here, consider the following possibilities:
You have selected the wrong patient or claim: Double check that the patient is not entered in your system twice, and use the function keys to verify that the charges in question were actually posted for this patient.
The charge is no longer pending an insurance carrier: Press F6 – Correct Mistakes to review or change the pending status of any charge on the account.
The charge is the responsibility of some other guarantor account: Perhaps the patient was recently moved from one guarantor to another. Press F2 – Other Guarantor to view pending charges for this patient that exist on different accounts. Note that this key will not be available unless such charges exist.
The charge was already paid off: Press F8 – Family Editor and then F3 – Collection Report or F8 – Account History to research account activity and outstanding charges.
The charge was deleted: If none of the above explanations help you find the missing charge, it may have been deleted completely. How can you know for sure? A good first step is to review the Day Sheet (
daysheet) report for the dates in question. For a family-specific record of activity, you can run the Daysheet History report (
dsscan) for the guarantor account in question.
If you still have trouble finding charges or would like to learn more about the issues described above, contact PCC support at firstname.lastname@example.org or call 1-800-722-1082.
Function Keys on the Insurance Charges Selection Screen
Function keys on the Charge Selection screen will help you perform a variety of other billing-related activities.
F1 – Next Patient
Press F1 to clear this patient and find a different one.
F2 – Other Guarantor
Press F2 to see insurance charges for this patient which are attached to an account other than their current guarantor. This key only appears if the patient has pending charges on other guarantor accounts.
Press F3 and then enter item numbers to create tags for later claim generation. You can then create the claim later using the
Press F4 and then enter item numbers to immediately print a HCFA 1500 claim form.
F5 – Print A Bill
Press F5 – Print A Bill to jump to the
bills program for this specific account. You could use this function to generate a personal bill immediately after posting an insurance payment.
Press F6 to run the
oops program for the patient’s guarantor account. In [prog]oops[/prog], you can change the pending status of charges, unlink and relink payments, resubmit claims, correct errors, and more.
F7 – Family Editor
Press F7 to run the Family Editor (
fame) for the patient’s guarantor account. In
fame, you can update demographic information, view a collection or account history report, print form letters, and more. After dealing with a difficult billing situation, you could add an account note in
F8 – Post A Refund
Press F8 to run the
refund program. In
refund, you can refund personal credits and post other account corrections that add a charge or offset a payment.
Press P to run the Post Regular Payments program (
pam, you can record personal payments and post account corrections that reduce the account’s balance or offset a charge.
Press I to open the patient’s Insurance Policy screen. In
policy, you can review the patient’s plan history, add or remove policies, or make other adjustments.
Payment and Adjustment (Screen Reference)
After you enter a Claim ID number, or find a patient and select charges, the manual Post Insurance Payments (
pip) program displays the Payment and Adjustment screen.
On this screen, you can enter payment and adjustment amounts for each charge that you selected. You can also specify how the payment or adjustment should be labeled, and you can select a responsible party for the remainder due.
The charges you selected will be listed with their date of service, procedure code, amount charged, and the contractually “allowed” amount (if known). Press Tab or Enter to move among the Payment and Adjustment fields. You can review and edit the payment type and responsible party fields at the bottom of the screen. Press F1 – Save Payments to save and post payment and adjustment amounts.
Payment and Adjustment Types: Practices sometimes use different Payment and Adjustment Types, which are located in the “Payment Types” table in
ted, to add a note to the account history explaining payment or lack of payment. If an adjustment amount is $0.00, however, you must turn on an option in
ced for the adjustment type to be recorded in the history. The use of custom Payment and Adjustment types is used less and less now that CARC is an industry-wide standard.
Withhold Column: The Post Insurance Payments program supports a third “Withhold” column, which would allow you to record even more information. You can activate the Withhold column by running
pip -w instead of
pip. Contact PCC at 1-800-722-1082 for help configuring and using different columns in
Print a Claim When Finished: If your office always prints time-of-service HCFA forms,
pip will ask if you need a new paper HCFA. The question will only appear if the payments or adjustments posted result in the charge pending a secondary insurance company.
Enter CARC Values
The Payment screen can also accept CARC values, the insurance industry’s set of standard payment and adjustment reasons.
If you post CARC values in
pip, you can then see them in programs like
oops and they will also appear on patient bills. Additionally, you must enter CARC Amount and Group information if you wish to submit a secondary claim electronically.
When CARC features are turned on at your practice, you will see a CARC line underneath each charge.
For each charge, you can enter a CARC amount, code, and group code. If you only wish to enter the CARC codes, you can press F7 – Hide CARC Fields to switch to a simpler view.
Contact PCC Support for help turning on the CARC value column in pip.
Do Not Post Other Carrier Codes: If your insurance carrier uses a non-CARC system of coded messages, do not post them in the CARC column. CARC values are a national standard and do not match up with Georgia Medicaid message codes or other carrier codes. Instead, some Partner users use payment and adjustment types to indicate messages from carriers.
Configure CARC in pip: CARC support in Partner may be deactivated at your practice. You can turn it on in the Charges and Payments section of the Configuration Editor (
ced). You can also select whether one or three CARC fields appear. Contact PCC Support for assistance.
For more information, read the CARC in Partner help article.
Work with Allowed Amounts (Contract Fee Schedules)
The Allowed column displays the contractual reimbursement amount for the fee. The amount will only appear when the responsible insurance has an assigned allowable schedule in the Insurance Table in the Table Editor, and when that assigned schedule has a fee entered for the date of service of the charge.
The assigned allowable schedule for the responsible insurance is displayed in the lower-left corner of the screen, if available.
You can jump directly into the Contract Fee Schedule Editor (
allowedit) for a given procedure by pressing F8 – Config Allow.
Payment Type, Check Number, and Responsible Party Fields
Use the fields at the bottom of the screen to modify the label and behavior for the payment:
Payment Type: This is the label that will be attached to the payment. Whenever you review the account’s history, this is what you will see next to the payment. In most cases, the name of the insurance carrier will be appended to the Payment Type once you post it. In addition to CARC values, practices can use different payment types to indicate why a payment was $0 or to simplify reporting on different kinds of payments. Enter an asterisk (*) in the field to see payment types your office uses. The default value for this field is “Ins Pmt”.
Adjust Type: This is the label that will be attached to the adjustment. Whenever you review the account’s history, this is what you will see next to the adjustment. In most cases, the name of the insurance carrier will be appended to the Adjustment Type once you post it. In addition to CARC values, practices use different adjustment types to indicate special adjustment circumstances. Enter an asterisk (*) in the field to see adjustment types your office uses. The default value for this field is “Ins Adj”.
Current Insurance: The Current Insurance field shows the current responsible party for these charges. The payments and adjustments you enter will be recorded as coming from this carrier. In almost every situation, the EOB and check you have received will match the Current Insurance field.
If you have received payment from a different carrier, double check that you have selected the correct patient, date of service, and charges. Or, back out of the program and enter it using the Clam ID number. You may want to press F2 – View Account and review the account history before continuing.
Next Insurance: If the payments and adjustments you enter do not fully pay off the charges, then the remaining amount will be pended to the next responsible party or “Next Insurance.” You should always review the Next Insurance field as it determines what will happen to the remaining charge once you press F1 – Save Payments.
Partner fills the Next Insurance field in for you: if the account has a secondary insurance, it will appear in the field. If the account does not have a secondary insurance, the word “Personal” will appear. If there is no secondary insurance but the charge in question can also be covered by Medicaid, then “Medicaid” will appear. If you need to change who the next responsible party should be, you can Tab to this field. Enter an asterisk (*) to see a list of choices for this account.
Medicaid Status: A charge is a Medicaid charge if the patient had a Medicaid status flag assigned when the charge was posted or the charge was later marked as Medicaid in
Check Number: This number will be recorded with the payment. If you consistently enter a check number when you post payments, you will have an advantage when dealing with payment mistakes across multiple accounts. You will also be able to list all patients to whom a particular check was posted.
Function Keys on the Payment and Adjustment Screen
If you need to check account information or history, press F2 – View Account or F3 – View Patient. You can also view a quick demographic synopsis by pressing Page Down.
If you do not recognize a procedure code and wish to review the procedure name, press F4 – Procedure Names to toggle between displaying the Allowed column and displaying the names of procedures.
If you wish to edit the Allowed amount or review the allowable schedule for an amount, press F8 – Config Allow to run the Contract Fee Schedule Editor.