If an office is 100 percent accurate at inputting insurance payments, they would never have insurance credits. Unfortunately, no office is perfect. This page is designed as a help to clean up the insurance credits you may have in your system.
What is an insurance credit?
An insurance credit is an insurance payment that was incorrectly posted inside the system.
To find out whether or not you have insurance credits, first print out an Insurance credit listing report. To do this, go to Reports, Financial, Credit Listing - Insurance. Then click Print.
There are two types of insurance credits: positive balance and negative balance.
Fixing insurance credits (with a positive balance):
1. Click on the Activities menu, then click Enter Payments.
2. Click on the magnifying glass next to Search Payments.
3. Check the box next to Show All Payments. After the box is checked, uncheck it. You should now see all the credits in your system, both Insurance and Patient credits. The Insurance credits are indicated with an 'I' on the left hand side.
4. On the right hand side, look for two columns named Amount and Unapplied at the top. The Amount column will show the payment amount that was entered, and the Unapplied column will show the amount that was not disbursed toward any transactions.
5. To correct this credit, simply double-click on it. This will bring up the payment screen with the details of the payment. The reason why this payment is listed as an insurance credit is because the Total Pmt field (just above the Post button) does not match the Amount field (at the top).
6. Using the Date Paid field, you will need to find your Explanation of Benefits (EOB) for that Date. The bottom rectangular box in the Payment screen indicates the patient, date of service, and procedure code that this payment has already been disbursed toward. The following scenarios will likely exist:
a) Scenario #1: Incomplete payment - Basically, the entire amount of the payment was not disbursed. If that is the case, look at the top rectangular box for the remaining patient(s) on this EOB, and finish disbursing the payment. Once the Total Pmt field matches the Amount field, hit post.
b) Scenario #2: Payment already posted - In this scenario, the Amount field and Unapplied field is usually the same. This can happen if the payment got posted incorrectly the first time, then correct the second time. If that is the case, there won't be anything to apply the credit to. If this scenario is true, you can delete the payment by clicking Delete (Entire Payment). Caution: ONLY DO THIS if you are certain that the payment was already entered into the system.
Fixing Insurance Credits (with a negative balance):
A credit with a negative balance is usually created when the user forgot to fill in the Amount box on the payment screen. To correct this, do the following:
1. Click on the Activities menu, then click Enter Payments.
2. Click on the magnifying glass next to Search Payments.
3. Check the box next to Show All Payments.
4. You should see a column at the top right of this window that says Unapplied. Double-click on that column (make sure you are double-clicking right on the word "Unapplied").
5. This will numerically list all unapplied payments. Now, scroll up to the top.
6. At the top, you should see all your negative credits. To correct these negative credits, simply double-click on them.
7. Now, fill the amount in at the top (it should match what you have filled in for Total Pmt). Then hit Post.