Posting Methods

There are two ways of Posting Explanation of Benefits (EOB) entries on the Post Insurance window, [1] Line Item Posting and [2] Global Posting. Although Global Posting is easier and faster, Line Item Posting is of much greater benefit to the practice.

In some States, Line Item Posting is a legal requirement. Some participating provider insurance contracts require Line Item Posting. If the practice prefers to use Global Posting, be sure to verify the laws, rules and regulations as well as contractual obligations in the State in which the practice is located.

Line Item Posting is very accurate.  Using Line Item payments and other adjustments to the patient account are performed at a service line-item level of detail. For each item on the EOB received from the insurance carrier there will be a Line Item in the Post Insurance window.

For each Line Item, an entry is made showing the amount Paid, the amount transferred to Patient Responsibility, and/or the amount of any Write Off.  This relates directly with the insurance company’s computer system and will provide the highest level of detail and Practice Statistics, as well as the best audit trail.

When using Line Item Posting, the Paid, Patient Responsibility, and Write Off are entered on the line the entry applies to. After a Payment amount has been entered in the Paid field on the Post Insurance window, there is the option to click the Apply Refused/Writeoff% button. The Apply Refused/Writeoff% button looks like a single sheet of paper that was cut into 2 pieces. This is for an agreement with the patient. If the Transfer and Write Off amounts are based on a contract with an insurance carrier, then the entry needs to be made in the Intelli$ense Fee Schedule of the Insurance Carrier Catalog for the patient’s specific Insurance Carrier.

Line Item Posting makes the practice aware of which services are getting paid, and which are literally being given away for free. Line Item Posting enables the practice to know when the insurance carrier is/is not complying with the fee schedule agreed to in managed care or participating provider contracts. 

The practice will find Line Item Posting to be the most beneficial form of data entry, although it is more labor intensive than Global Posting.

With Global Posting payment is posted to the whole claim without the effort of associating payment to a particular service.  This is by far, the easiest method of posting claims. The practice receives a payment from the insurance company and staff makes a single entry to apply the payment to one claim regardless of the number of lines of charges covering multiple dates and services. 

In order to post a payment in Global Posting, click on the claim to highlight it. Next, go to the bottom of the window and enter the payment amount in the Paid box. For each line of entry, there is the option to enter Remarks that apply to that item. After a Payment amount has been entered in the Paid field on the Post Insurance window, there is the option to click the Apply Refused/Writeoff% button. The Apply Refused/Writeoff% button looks like a single sheet of paper that was cut into 2 pieces and for Global Posting is located to the right of the Payment box at the bottom of the Global Posting window. This is for an agreement with the patient. If the Transfer and Write Off amounts are based on a contract with an insurance carrier, then the entry needs to be made in the Intelli$ense Fee Schedule of the Insurance Carrier Catalog for the patient’s specific Insurance Carrier.

If you are posting several claims or line-items with a single insurance check, you may enter the check number and the amount of the check into the Distributed Check Info area at the top of the Post Insurance Ledger window. Then post all the items. Post payments to all the Line Items or Global Claims, and the Funds Remaining box will display the amount of the check that is remaining.  The check number and total amount will be filed with the Remarks of each Line Item or Global Claim. Click the Save icon only when finished with all the items.

When posting insurance claims, sometimes it is necessary to seek payment from additional carriers.  In the patient’s Insurance Policy window there is the ability to tell the system that After Payment Resubmit To. If the next carrier in line has been entered in the patient’s Insurance Policy window then that carrier can be entered in this box. If the patient’s primary carrier does not completely cover a service or services, ChiroOffice will ask if the claim should be resubmitted to the next carrier in the patient’s file. The system will produce a new claim for the secondary carrier for the amount remaining. Since the Explanation of Benefits from the primary carrier must accompany the submission to the secondary carrier, make sure that the secondary carrier is set in the patient’s Insurance Policies area to a form type of CMS-1500 or to the proper electronic format IF the clearing house used by the practice has the ability to resubmit secondary claims.

Claims may also be resubmitted on demand to any insurance carrier in the patient file. Just follow these steps:

•      Click on the claim to resubmit so it is highlighted

•      At the top right, click on the drop down arrow in the Resubmit To box and select the carrier to Resubmit the claim

•      Repeat these steps for each claim that is to be resubmitted.

•      Click the Save icon when finished

•      The next time Insurance Manager is accessed, the claims will appear for re-submission.