Filopto Help Manual

Insurance Mufti-Payment Screen

 

The Enter Payments for the selected Insurance Company button permits users to enter and record multiple payments for a given insurance company. This function is available from the back Office - Accounting & Insurance tab and from inside the Insurance Accounts Receivable screen.

 

 

 

When an insurance company is selected and the button is clicked, the following screen will be displayed.

 

 

Top Section (1): Displays the selected insurance company and cheque payment information.  Enter the Payment Date, Payment Method, Cheque Number and Amount of the Cheque (Payment Amount).

 

 

 

 

 

Enter Insurance Payments

 

 

1) Enter the Payment Method, Cheque Number and Amount of the Cheque. If using a vPay or vCard you can enter the VPay or VCard number in the check number field

 

2) Find and Select the claim to be paid and enter the amount of the payment in the Amount Paid by Insurance Company field(1). The Payment and Adjustment screen will be displayed listing the items sent to the insurance company for payment. If you receive a line item detail payment list from the insurance company you can allocate the payment made to each item. If you only get a bulk payment then you can distribute it as you wish against the items listed (2).

 

You can use the Find tool for the grid to quickly locate a patient claim record

 

 

 

 

1) The Search for Invoices Without Claims (1) button allows users to open the Invoice Manager with the preset settings to display all invoices with no claims created providing users with the ability to quickly locate the invoice of a patient whose claim in Filopto has not been set to submitted and thus not available in the Outstanding Insurance Claims grid.

 

2) The Add Newly Created Claims (marked as Submitted) (2) button will load into the payment screen any newly created claim or claim whose status has been changed to submitted,  to the list of claims in the Outstanding Insurance Claims grid.

 

 

Once a patient claim record is located select the Amount Paid by Insurance Company field to record the payment.

 

 

You have two options to record the selected claim payment:  

 

 

1) Single Payment amount that will be applied for the whole claim

 

IMPORTANT: The Single Payment will proportionately distribute the total payment to each claim line item.  Once the payment is distributed, users can make adjustment per line item claim, but it is the users responsibility to make certain that any adjustment to the distributed amounts are equal to the total payment amount entered.  

 

2) Individual claim line item entry, which permits detail tracking of payments as provided by the insurance payor.

 

 

Claim Single Payment Method

 

The single payment method permits you to record one payment for all claims line items associated with the selected claim.  Users can also automatically write-off any remaining amount of a claim by placing a check mark in the Write-off the claim balance field.  Users can also transfer the balance to a secondary or third payor by placing a check mark in the Transfer the balance to the next insurance filed

 

 

 

Claim Line Item Payment Method

 

By selecting and entering the payment in the Payment Amount field (2) and then selecting the Write-off/Adjustment Total field (3) to enter adjustments using the Add an Adjustment (4) button.  The adjustment button allows a user to enter and write-off any amount associated with the detail claim line item. Note that a Write-off is a negative  adjustment which must be entered in the Adjustment Amount field.

 

 

 

Write Offs / Adjustments / Transfer Amount to Patient (4)

 

A write off is a a cancellation of an amount from an account such as a bad debt or worthless asset.  In the USA  insurance companies some times do not cover the full amount of the submitted claim.  You are then required per the terms of your agreement with the insurance company to write off the amount remaining after their payment.  Filopto provides for this procedure by allowing you to write off any remaining amount (user can specify the amount) in the Insurance payment screen.

 

If you require to do some write off or Adjustments you can enter the amount of the write off in the appropriate Payment and Adjustment screen field (3) for the line item.   To add an adjustment or write off select the Add an Adjustment button.

 

 

The Entry screen is displayed.  Complete the required fields to record your Adjustment, Write off or transfer amount to the patient option.  Note that if you choose a Write Off the amount you enter will be automatically changed to a negative number (reducing the claim).

 

 

 

Once an adjustment is recorded against a claim it can be edited or removed by directly editing the displaced record in the grid.

 

 

 

Transfer to another  Insurance Company

 

You can also transfer from the Payment and Adjustment screen the remaining or portion thereof of the unpaid claim amount to another insurance company, if the patient has additional insurance companies on record. If no additional active Insurance companies exist on the patient file this option is not displayed.

 

The user can enter a value or choose the Apply Balance (1) button to transfer the amount remaining to be paid for the claim.

 

 

If any amount was entered in the " Amount to Transfer to Other Insurance" field, the system will automatically generate and prepare the Next Claim for the next insurance company taking into account the payment made up to date.

 

 

 

Reject Codes

 

You may also record any reject code provided by the insurance company.