Post Less-Common Payments
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Post Less-Common Payments (6.5 min • 2024-02)
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Learn how to record capitation payments, incentive payment, insurance interest payments, withhold payments, and overpayments in PCC EHR.
Related Articles
- Here are some related articles in Billing and Practice Management > Post Insurance Payments and Adjustments:
Post Capitation Checks, Incentive Payments, Interest Payments, Overpayments, and Withhold Payments
Learn how to record capitation checks, incentive payments, insurance interest payments, payment amounts that exceed the amount due on a charge ("Overpayments"), and end-of-year withhold payments- Every insurance claim in your PCC system has a unique identification number. The number appears in various reports and programs, and you can use it to improve claim tracking and payment posting.
Reverse an Insurance Payment (Post a Takeback)
From time to time, insurance companies will ask you to reimburse them for an overpayment. Sometimes, the company will ask you to send them a refund check. Sometimes, they will underpay you for more recent charges in order to make up for the overpayment on an old charge.- When insurance carriers send payment and adjustment information, either on an EOB or an ERA, they often include a code with a small message. These codes are known as CARC values, or Claim Adjustment Reason Codes, and they are an industry-wide standard.
- After a payor reviews your electronic claim, they will send your practice an explanation of what charges are paid, adjusted, or denied.
Post Insurance Payments and Adjustments
Automatically post ERAs sent to your practice. If a payor's response requires direct attention (or you receive a paper EOB), you can manually post the payments and adjustments.- Process an ERA in PCC EHR and automatically post payments and adjustments.
Reverse an Insurance Payment (Post a Takeback)
When an insurance company or other payer reverses a payment, also called a "takeback", use PCC EHR's Insurance Payments tool to quickly reverse the payment and post the new adjudication information for the claim.Manually Post Insurance Payments and Adjustments
Learn how to manually post insurance payments and adjustments in PCC. Along the way, you can change the copay due on a charge and use PCC EHR's components to work with policies, demographics, and account notes. After posting, you can review payment histories and edit or delete the payments.- Use the Electronic Remittance Advice tool in PCC EHR to read any ERA on your system and review the adjudication for a claim.
- When you need to review the insurance company's full response to a claim submission, how do you open and work with the ERA 835 file in PCC?
Review and Prove Out Insurance Payments by Check Number
Your practice can reconcile posted insurance payments with two different reports in the Report Library.