Post Payment Received from Insurance

If the health insurance you work with does not offer electronic EOB/ERA (just paper one), you will need to post payments from the health insurance manually. 

In addition, if you're enrolled for EOB on TheraPlatform, but you're sill waiting for insurance to complete the enrollment on their end, you would need to post payments manually till the insurance completes the enrollment on their end.

There are multiple workflows for posting payments manually. You can post them form the client's chart, from Billing and Calendar.

Note: To post payments from insurance manually, the claim needs to be in "Accepted" status. 

Here are directions on how to post payments from health insurance manually.

From Billing

After you receive the paper version of EOB, you will need to locate the invoice with a date of service on TheraPlatform so you can post the payment:

Step 1: Click on Billing.

Step 2:  Click on Invoices.

Step 4:  Here you can filter invoices with different filters:

• Click on Invoice Id to filter by invoice id number
• Click on three dots to filter with: mark with claims and search for specific client with client search bar, etc. 

Step 5: Next find the invoice number and date of service that you need to post a payment from insurance and click on the eye icon next to the invoice. 

Step 6: This will open the invoice, click on View claim at the bottom of the invoice.

Step 7: This will pull up the claim, click on "Mark as paid" (this will change the status of the claim to paid) and after you mark it as paid, you will see another red button at the bottom of the claim EOB

Step 8: Click on "View EOB" button and click on "Edit" button and refer to the statement you received from the insurance in mail.

Step 9: Enter "Allowed Amount" which is the amount insurance paid for the claim.

Step 10: Enter "Client Amount" which is the client responsibility amount for the claim 

Step 11: Enter Remittence Day and TraceNumber shown on the paper statement and click on "Save" button.

Step 12: Click on "Add Adjustment" and select related claim item, Group Code, Reason Code as show on the statement from insurance. 

Step 13: Repeat step 12 for each adjustment presented on the statement for the claim.

Step 14: Please, note that the amount you entered on the "Client Amount" must be equal to the sum of all adjustments marked with "PR" group (Patient Responsibility). It is also important to enter all adjustments so the write-off amount can be calculated correctly.

Step 15: Once you enter all adjustments and want to update your invoice click on "Apply to Invoice" button.

Step 16: System will update your invoice and will adjust line items "Client Total", "Insurance Total" and "Insurance Write Off".

Step 17: Once you complete these steps you can open the invoice and click on "Add Payment" to apply payment from the insurance on the invoice.

Alternatively, you can follow the above steps but instead of clicking on Invoices (under step 2), you can click on Claims. 

From Calendar

Step 1: If you're a biller or the admin and the service was provided by other than you therapist, click on Schedule and switch the calendar to your therapist's calendar first.

Step 2: Then click on the date of service (on scheduled appointment).

Step 3: A the pop-up box, click on View Invoice to open the invoice.

Step 4: At the bottom of the invoice, click on View claim.

Step 5: This will pull up the claim, click on "Mark as paid" (this will change the status of the claim to paid) and after you mark it as paid, you will see another red button at the bottom of the claim EOB

Step 6: Click on "View EOB" button and click on "Edit" button and refer to the statement you received from the insurance in mail.

Step 7: Enter "Allowed Amount" which is the amount insurance paid for the claim.

Step 8: Enter "Client Amount" which is the client responsibility amount for the claim 

Step 9: Enter Remittence Day and TraceNumber shown on the paper statement and click on "Save" button.

Step 10: Click on "Add Adjustment" and select related claim item, Group Code, Reason Code as show on the statement from insurance. 

Step 11: Repeat step 12 for each adjustment presented on the statement for the claim.

Step 12: Please, note that the amount you entered on the "Client Amount" must be equal to the sum of all adjustments marked with "PR" group (Patient Responsibility). It is also important to enter all adjustments so the write-off amount can be calculated correctly.

Step 13: Once you enter all adjustments and want to update your invoice click on "Apply to Invoice" button.

Step 14: System will update your invoice and will adjust line items "Client Total", "Insurance Total" and "Insurance Write Off".

Step 15: Once you complete these steps you can open the invoice and click on "Add Payment" to apply payment from the insurance on the invoice.

From Chart

Step 1: Click on Clients.

Step 2: Click on the eye icon next to the name of your client or start typing the name of your client in the upper client search bar. Select the client and this will open the chart.

Step 3: Click on Sessions< Invoiced.

Step 4: Click on View Invoice to open it.

Step 5: At the bottom of the invoice, click on View claim.

Step 6: This will pull up the claim, click on "Mark as paid" (this will change the status of the claim to paid) and after you mark it as paid, you will see another red button at the bottom of the claim EOB

Step 7: Click on "View EOB" button and click on "Edit" button and refer to the statement you received from the insurance in mail.

Step 8: Enter "Allowed Amount" which is the amount insurance paid for the claim.

Step 9: Enter "Client Amount" which is the client responsibility amount for the claim 

Step 10: Enter Remittence Day and TraceNumber shown on the paper statement and click on "Save" button.

Step 11: Click on "Add Adjustment" and select related claim item, Group Code, Reason Code as show on the statement from insurance. 

Step 12: Repeat step 12 for each adjustment presented on the statement for the claim.

Step 13: Please, note that the amount you entered on the "Client Amount" must be equal to the sum of all adjustments marked with "PR" group (Patient Responsibility). It is also important to enter all adjustments so the write-off amount can be calculated correctly.

Step 14: Once you enter all adjustments and want to update your invoice click on "Apply to Invoice" button.

Step 15: System will update your invoice and will adjust line items "Client Total", "Insurance Total" and "Insurance Write Off".

Step 16: Once you complete these steps you can open the invoice and click on "Add Payment" to apply payment from the insurance on the invoice.

Note: TheraPlatform (Plans Pro and Pro Plus) offers EOB/ERA and if the health insurance you contract with, offers EOB/ERA, you can enroll right on our platform. Once the enrollment is completed payments from the insurance will be automatically posted on TheraPlatform.

When you add health insurance in TheraPlatform that you work with, our system will notify you right away if this health insurance offers EOB/ERA enrollment and you can sign up for EOB/ERA so payments from the health insurance are posted automatically in TheraPlatform.