Functions and Features of the Post Insurance Ledger Window

At the top of the Post Insurance Ledger window are several items that benefit the practice and enhance the functionality of the window.

At the upper left of the window is the Posting Method Selection Box. This will display the default method selected.

The practice has the option of setting either Line Item or Global Posting as the default that will appear when the Post Insurance window is opened. To set the default preferred by the practice, at the Front Desk window, select Tools ► Settings ► Insurance to set the default for either Line Item Posting or Global Posting. Once set, the Post Insurance Ledger window will always open to the method that had been selected.

In the event that the window opens to one method, but for this patient, the other Posting Method should be used, simply click on the drop down arrow in the Posting Method Selection Box and choose the other method.

To the right of the Posting Method Selector is the Carrier button. Each claim listed displays the Carrier that it was submitted to. When a claim is highlighted on the list of either Open Claims or Closed Claims, whether set to Line Item or Global Posting, clicking on the Carrier button opens the Insurance Carrier Catalog to the Carrier assigned to that claim.

When the Insurance Carrier catalog is opened from this window it is fully functional and allows the option to make changes in the Insurance Carrier file. Note that any changes made will apply to the Carrier, that is, those changes will affect every patient covered by this Carrier.

Click the Intelli$ense button to open the Intelli$ense window. There are times when it is necessary to revise the Fee Schedule that was established for this Insurance Carrier. Open the Intelli$ense window, click on the Fee Schedule tab, and add, edit or delete whatever is necessary. Note that any changes made will apply to the Carrier, that is, those changes will affect every patient covered by this Carrier.

The Intelli$ense window for each Insurance Carrier is usually set up in the Insurance Carrier catalog.

The LI (Line Item) Auditor button enables the office staff to verify that all Payments, Credits, Transfers, and Write Offs have been correctly assigned to Dates of Service. The LI Auditor button is visible and functions only when the Posting Method is set to Line Item Posting. If the Posting Method is set to Global Posting, the LI Auditor button is hidden since it does NOT apply to Global Posting.  Click the button to open the Line Item Auditor.

The LI Auditor checks either Open or Closed Claims, based on the selection made in the Status box at the upper left of the LI Auditor window.  If anything is NOT properly linked, the information will appear on the screen providing the ability to Assign Selected Transactions and/or Delete Excessive Credits that have resulted in negative balances.

In the event that the LI Auditor finds claims that require attention, those claims will be listed in the box at the left located under the Status selection box.

Select a Claim by clicking on it, and the information about the Claim is displayed in the Service Line Item(s) box. Any Financial Transactions that need to be Assigned or Deleted are displayed in the lower Financial Transactions box.

Click the appropriate button at the bottom of the LI Auditor window to complete the necessary actions.

There are those patients that require an insurance claim to be produced outside of the normal practice routine. On this window, the Create Quick Claim button is the New icon (the one with the green starburst). Click on the Create Quick Claim button to create the insurance claim. This will create a new insurance claim for all the visits that have not previously been submitted. There will be a pop up that shows the number of claims created and the total amount of those claims. Click OK.

To print or electronically submit the Claim, go to Tools > Insurance Manager > Claim Registry Tab. Select the Type from the drop down box. Once the list populates, either Print the paper claims, Transmit the GatewayEDI claims or Output and upload the Print Image claims.

To the right of the Create Quick Claim button is the Save button. After entering and posting Payments, Transfers to patient responsibility, and Write-offs on the Post Insurance Ledger window, it is critically important to Save the entry. Post the entries and click the Save button. If the Save button is NOT clicked, the data entered is lost.

It is best to NOT remove any claim that has been produced and submitted. The Claim Removal button was intended for use only when a Claim was produced in error and NOT submitted to any insurance program. Use this button ONLY with exceedingly great caution!

On extremely rare occasions it may be necessary to completely remove, that is permanently delete, a Claim, including Payments, Transfers (rejections), and Write-Offs that had already been applied to it. All historical Properties information about the Claim is also removed. The Claim Removal button is the Garbage Can icon.

Click on the Claim to highlight it, and then click on the Claim Removal button. A pop up message will appear asking for confirmation to Remove the Claim. Click Yes and the Claim is deleted.

All the Transactions that had been on the Claim are reset to Not Billed. This enables the creation of a New Claim for the involved Transactions.

Any Payments, Transfers, or Write-Offs that had been applied to the Claim will require Re-Entry after the New Claim is created. If there will be no New Claim, then the Payments need to be entered on the Transaction window as Patient Payments.

Once in a while, as entries are made, a mistake is noticed. After making entries, but prior to Saving the entries, click the Undo button to remove the error. The Undo button is a circular arrow pointing to the left. This removes the incorrect entry only on the line that the cursor is on.

For example, when using the Line Item Posting method, several line item entries may have been made when it is recognized that one line was entered for the wrong date. Provided that it is BEFORE the Save icon has been clicked, Click on that line item and then click on the Undo button.

The Printer icon enables the reprinting of a claim. The reprint will be in the format that the original claim was produced (paper or electronic). If this will be a  paper claim, verify that the CMS-1500 is in the printer.  Click on the line so the claim is highlighted. Click the Printer icon. The selected claim will be produced.  

The system will ask if you want to print Claim Attachments when producing a paper claim.

When creating a new electronic claim, the system will ask if a new Print Image file should be created. Answer Yes will delete the previous Print Image file. Answer No to add the new claim to an existing Print Image file. Then upload the Print Image file to the clearing house.

For any number of reasons there are insurance claims that require correcting information on a claim and then resubmitting that claim. Incorrect information that was originally on the claim needs to be fixed in the patient file. The correct information needs to be entered in the patient’s Insurance Policies window. Relock Insurance Information applies only to Open Claims. Relocking updates the claims to include the most current information from the patient’s Insurance Polices window.