Get Paid! 🙌 In this lesson we’ll cover the following Insurer Payment topics:
- Managing Insurer Payments
- Posting an Insurer Payment EOB
- Posting an EOB Example
- Posting a $0 EOB
- Delete or Unapply an Insurer Payment
- Courtesy Billing
All payments received by Insurers can be managed by heading to the Billing tab, and scrolling down to find the Insurer Invoices section on the left:
Click on the Insurer name to display all Billing information for this payer.
The Purchases page lists for you all invoices for this payer. This list of invoices can be filtered at the top of the page.
The Payments tab lists all payments recorded from this payer.
The Claims tab provides a full list of Patients who have coverage (a “claim”) with this payer.
Insurance payments can be posted in a few different areas in Jane (i.e. through an individual patient’s purchase). Our recommended workflow is to post payments under Billing > Insurer Invoices > New Payment
You will see the New Payment screen open where you can record the amount received and the payment method (i.e. insurer check).
When you hit Next, a payment is recored and can now be applied to multiple invoices.
After clicking Next, search for the purchase you’d like to apply this payment to:
Click Edit to record the EOB (Explanation of Benefits) in detail:
Now, you’ll need to enter what was approved for each code and update the patient responsibility using the information from the EOB. Please note that the information on the payer’s remittance might look a little different than Jane’s EOB screen (we provide a link to an example EOB further down this guide).
You can then update the patient responsibility if needed. Updating the patient responsibility will update the private outstanding balance on the patient’s account, so that you can collect at your convenience!
After you’ve inputted the approved amounts and updated your patient’s responsibility, you can see a breakdown of what was entered in the bottom right hand corner of the screen.
From this screen you can choose to write-off any remaining (uncovered, adjusted etc.) amounts, pass the remaining to the next payer/patient, or leave it as a balance owing.
To finish, click the Apply Changes button.
Voila, our payment is recorded and posted!
Payments can also be posted from the Appointment window:
and inside the Patient Profile > Billing:
Pay and Approve You might have noticed the Pay and Approve button in the images above. So, what is Pay and Approve anyway? If you click the Pay and Approve button just know that Jane will create an insurer payment only in the amount due for just that appointment. That means that if your insurer sent one large payment covering multiple visits - the Pay & Approve button will not be able to record that information. There also is no option to select the Insurer Payment method. Our recommended option here would be for you to use the Record Payment in Detail button. But if you do decide to use Pay and Approve… we won’t judge you ;)
If you want some additional guidance on how to record your EOBs in detail, please have a look at the following guide where we walk through an example:
Have you received a $0 EOB and need to record it in detail? Maybe the patient hasn’t met their deductible and you still need to record what was approved for each code.
If so, hop into this guide to learn more: Posting a $0 EOB
There are a number of reasons to want to unapply a payment from an insurer invoice - whether it be to create a credit towards that insurer, refund a payment, or even just temporarily unlink the payment from the invoice to edit some of the coverage details.
To learn how to unapply an insurance payment, hop into the this guide:
If you have entered a payment in error, and instead need to delete the insurer payment, follow the steps outlined in the following guide document:
On every Jane account, the insurance billing default is set to Collect from Insurance. This means that you are expecting the insurance company to pay you rather than send the money directly to the patient. However, you do have the option to switch a purchase on your account to Patient Pre-Pay if you plan on courtesy billing.
Learn more about how this works here: Courtesy Billing or Patient Pre-Pay
📘 Continue learning the insurance billing workflow in Start Billing 7 - Cash Visits & Superbills