Fusion Enterprise understands that billing is a critical function of any practice. As such, we have ensured that you can run all of your practices billing through Fusion Enterprise and make it as easy as we can. This series of introductory articles will cover the important aspects of managing Postings with Fusion Enterprise.
Posting - Posting Carrier Payments
Selecting the Carriers tab will display the carrier payment entry portion of the module.
Carrier Payments
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Post Date |
The date for which the money needs to be posted. |
|
Type |
The type of money that is being posted. Current options are Cash, Check, Credit Card and EFT (Electronic Funds Transfer) |
|
Amount |
Amount of money that is being posted. |
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PLB |
The Policy Level Adjustment (PLB) for a given claim. |
|
Identifier |
An identifying field that can later be used to find the money. Typically this is entered as the check number, or in the case of credit card, the type. |
|
Claim ID |
The Claim ID is an aid to look up the carrier from which the posted money originated. The Claim ID is printed on a HCFA/CMS-1500 in box 26 in the format CCTXXXX with XXXX being the Claim ID. This Claim ID is then usually returned on the EOB from the carrier. |
|
Carrier |
The carrier from which this payment originated. |
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Holding Company: |
If there is more than one holding company associated with your operation then you will be able to select which company this check is being posted for. |
The following is a step-by-step guide of how a carrier payment would be posted.
Step 1: Determine and enter the post date of the check.
The post date is typically the date on which the money was deposited into the bank. Some clinics may decide to go with the date the money was received. How you decide to select a post date is up to you. We only suggest that an organization be consistent with their posting dates, as this makes your life much easier in the long run. Once a post date is entered, the grid at the bottom of the screen will populate with any payments that have already been posted for this date.
Step 2: Enter the type of payment.
Currently, the options are Check, Cash, Credit Card, and EFT (Electronic Funds Transfer). This classification also shows up on various posting reports and is an aid in balancing at the end of the day.
Step 3: Enter the Amount and PLB (if one is present).
Step 4; Enter the Identifier.
This information is later used to look up payments made by the carrier and is a necessity in the case of a refund. You would typically enter the check number.
Step 5: Enter whom the payment is from.
When a payment is applied to a case, the Carrier that the payment is from must match the Carrier that is assigned to a policy in the patient case. If these do not match, Clinic Controller will not allow you to apply the money. This helps eliminate cross-posting errors where you accidentally post money to the wrong patient account.
There are several ways to identify which carrier made the payment. The easiest method is to enter the Claim ID as it appears on the EOB. The Claim ID will take the format of CCTXXXXX, with XXXXX being a numeric Claim ID. (For example CCT123 is Claim ID 123). The CCT (Clinic Controller) portion of the Claim ID is provided as an aid when looking for the Claim ID on an EOB. As anyone who has looked at an EOB can attest, these forms can be particularly busy, and just the number portion of the Claim ID would be difficult to locate without the CCT prefix.
After entering a valid Claim ID, the Carrier Box will display the insurance carrier from which that claim was sent. In almost all cases, this carrier will be the carrier that should be credited with remitting payment.
NOTE: There is one exception here. In the case that the primary carrier automatically forwards the claim to the secondary for payment, the secondary EOB will contain the Claim ID of the claim that was originally sent to the primary. In this case, the carrier which remitted the payment must be identified in another manner.
To the right of the Carrier display field are two buttons with Ellipses.
Hovering the mouse cursor over them will identify them as Search for Carrier and Search by Patient. Clicking Search for Carrier will display the Select Carrier dialog. More information on this dialog can be found in Chapter 26: Cross Module Features. Clicking the Search by Patient will allow you to choose a carrier after first narrowing it down by patient.
After the carrier is properly identified, the enter key or Post button may be pressed to post the payment to the system.
Once payment is entered into the system, it will appear in the grid at the bottom of the dialog. There is more information on the payment grid later in this chapter.