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Line Item Payment

The Line Item Payment function is used to post insurance payments and/or adjustments against a specific line item charge on a claim. The allowed amount, deductible and co-insurance amounts can be entered to automatically calculate the paid amount. You can enter just the allowed amount and or adjustment to automatically calculate the paid amount. If you enter a deductible or co-insurance amount, they are deducted from the allowed amount to calculate the paid amount.

Each bold line displays the date of service for the charge, the CPT4 code, the total charge amount and the balance remaining on the line item. The remaining balance amount reflects posted payments/adjustments.

Setting the Final Payment Option transfers the balance on the claim to the next insurance or to the guarantor’s responsibility amount if there is no next insurance. Selecting the Print Immediately indicator will print the next insurance claim.

If a claim has more than four charges, the page buttons will be enabled. Once you are on the next page, you can use the page forward and backward buttons to get to the rest of the charges. If you choose to use page forward and backward buttons, you must select the OK button if you are entering payments/adjustments before you press the page forward button.

NOTE** You use Line Item Payment to reverse a posted line item amount or post a line item debit adjustment. A payment reversal is entered with a minus sign (-) to the right of the amount. A debit adjustment is entered with a minus sign (-) to the right of the adjustment amount

To Add a Line Item Insurance Payment/Adjustment to a Batch:

  1. Click on Payment/Adjustment on the top menu bar.

  2. Click on Line Item Payment - Claim.

  3. A list of all batches that have been opened but not posted will appear.

  4. Identify your batch, highlight and click OK.

  5. The patient search screen is presented. Select the patient for whom you want to enter a payment. You can search by patient name or account number. If you search by patient a list of the patient's accounts will appear. Identify the account highlight and click OK. If you search by account number you will either see a list of claims if the patient has more than one third party, or you will be taken directly to the line item payment posting screen.

  6. If the patient has more than one third party, a list of claims will appear. Select the claim you want to post the payment/adjustment to, highlight and click OK.

  7. The line item payment/adjustment screen appears. Enter the payment amount in the allowance field. Enter a transaction code describing the payment type. Click on the plus sign (+) to access a list of transaction codes. Enter the adjustment total in the Adjustment field. Enter a transaction code describing the adjustment type. Click on the plus sign (+) to access a list of transaction codes.

  8. If you want to enter the check number for the payment, enter it in the check number payment field.

  9. The check number field for the adjustment can be used for a check number or a brief note describing the reason for the adjustment.

  10. Repeat the appropriate steps for other charges on the account that need payments and/or adjustments applied.

  11. Turn ON or OFF the Final Payment indicator as necessary. Final Payment assures transfer of the remaining balance to the next third party, or if no third parties remain, to the guarantor responsibility amount.

  12. Check that the information you have entered is correct and click OK to record the payment and/or the adjustment in the payment batch.

  13. Press Alt-L to return to continue to the next account for the same patient.

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