Insurance Payments

Insurance Payment


After entering the base payment information, the next step is to enter the amounts applied to services, how much is overpayment or prepayment, and how much, if any, to enter as an adjustment.



Amount Available to Apply

This display-only field shows you how much of the total payment is available to apply to this patient and other patients. If this is a new payment, this will equal the payment amount. If part of the payment was already applied to another patient, this amount will be less than the total payment amount.


Show only services being paid

Check this box to show only services that are being paid by this payment. Otherwise all services with an outstanding balance will be listed. This box should always be checked when you are adding a payment but when viewing or editing a payment, it may be more useful to have it unchecked.


[Services] list

This shows the services that have outstanding balances. When the check box above the list is checked, the list will be limited to only those services being paid by this payment.


To apply payment to the highlighted service, you can double-click the service or click the Change button.


Total Applied to Services

This is a calculated field showing the total amount of this payment applied to services for this patient.



If you are entering a payment for services that have not already been entered, you can use this field for the amount that will be later applied to those services once they have been entered. If you are entering a payment that was in excess of the amount owed on services, you can put the overpayment amount here and then adjust it off and send the payer a refund.


Statement Comment

Enter here any comment that you wish to appear on patient statements for this payment.


Adjustment Amount

There are only a few reasons for adjusting a payment. The short list includes refunding an overpayment and reversing a payment that could not be collected such as a bounced check or a credit card charge back. The adjustment amount cannot be for more than the overpayment amount so you may need to zero some or all of the amounts already applied to services and enter the difference in the overpayment before you can enter the adjustment.


Adjustment Date

Enter the adjustment date. You can press F2 or right-click to select a date from the popup calendar.


Adjustment Comment

Enter here any comment that you wish to appear on patient statements for this adjustment.


Total Applied to this Patient's Account

This calculated field will show you how much of the payment has been applied to this patient's account.



IMPORTANT:   For reporting purposes, payment adjustments are treated as if the adjustment date is the date of the payment, even if the adjustment date is different. In other words, a payment in January with a February adjustment is included only on reports for January. This is important to understand especially with respect to provider income.