Piecemeal Payment Events

There are many situations requiring a biller to create a payment event by hand. This guide explains how to do it.

Before continuing, be sure you understand how AngelTrack calculates the balance due.

Paper accounting

Are You Entering Paper EOBs?

If you are regularly entering paper EOBs received from insurers, contact your clearinghouse and sign up for electronic ("EDI") documents. AngelTrack can process electronic insurance documents for you, saving you the enormous hassle of manual data entry.

HIPAA requires all US insurers to accept and to provide electronic documents in lieu of paper claims and paper EOBs. Only a few state Medicaid carriers flaunt the law by dealing exclusively in paper. Other than those rare situations, you should not ever need to file a paper claim or process a paper EOB.

To learn how electronic claims and electronic EOBs work, read the EDI Primer. To learn how to import an electronic EOB into AngelTrack, read the Importing X12.835 EOBs Guide.

Finding the dispatch ID on a paper EOB

AngelTrack's claim control numbers are distinctive, and so are easy to find on a paper EOB:

EOB with claim control number

This is assuming you used AngelTrack to code and file your claims; if you used a different billing application, then consult that application's help to learn what its claim control numbers look like.

To learn more about how to read a paper EOB, including how to find the AngelTrack dispatch ID, check out the Reading an EOB Guide.

Paper EOBs are Problematic

A well-run billing office enters at least 95% of its claims electronically, by importing the EOB datafiles directly into AngelTrack. Less than 5% of your payment events should be from paper EOBs, typed in manually. If you are doing more than 5% of your EOBs manually, call your clearinghouse and ask to be switched to electronic statements.

Manually-entered payment events have all of these drawbacks:

  1. Typographical errors
  2. Accidental duplications
  3. Incorrect "next steps" decisions (see "The 'Next Steps' Decision" below)
  4. Cannot electronically file any secondary claims*

*The reason that AngelTrack cannot electronically file a secondary claim when the primary claim was manually recorded (i.e. as a paper EOB) is due to the data required in an electronic secondary claim. Specifically, the secondary carrier must be sent the complete matrix of the primary EOB's service lines, allowed prices, and each service line's table of adjustments and CARCs. Because AngelTrack does not collect this from a manually-entered paper EOB, it cannot compose an electronic secondary claim.

Locating the Dispatch Record in AngelTrack

Payment events are always associated with dispatch records. Therefore to record a payment event you must first locate the dispatch record that incurred the payment.

Finding a dispatch record when you know its ID

The quickest way to retrieve a dispatch record, when you already know its dispatch ID, is to use the Genie. Simply press ALT+G from any AngelTrack back-office webpage (i.e. from any AngelTrack page that has a white background). The Genie will popover the current page, without disturbing your work there. Type in the dispatch ID and hit enter, and the record will load in a new browser window. Switch to the "Payments" tab and then click the + icon.

Although the Firefox web browser is not officially supported by AngelTrack, here is a tip for those who use Firefox anyway: the Genie's ALT+G shortcut doesn't work in Firefox. Instead you must click the magic lamp icon from the menu at the top of the page.

Finding a dispatch record when you know the patient record

If you already know the patient and have their patient record open, just switch to the "History" tab. It will show all of their transports, going as far back in time as you wish. Or use the "Receivables" tab, which shows just those transports with an outstanding balance.

Finding a dispatch record when you don't know its ID or its patient record

The Record a Payment Page has a combination of filters for rapidly locating any dispatch record. You can search by date range, patient name, dispatch ID, origin facility, patient date of birth, and service level. In the result grid you can click the $ icon to add the new payment event.

For example, suppose you are entering the data from a paper EOB. EOBs often list all services rendered to a patient over a period of time. In such cases, use the patient name and DOB fields to find all the patient's dispatches, and then use the 'Date of Service' filters to zoom in on just those dispatches covered by the EOB.

EOBs from Medicare and Medicaid often include the combined HCPCS code for the transport; for example, transport from a hospital (HCPCS code H) to a skilled nursing facility (code N) is listed as 'HN'. On the Record a Payment Event page, the list of dispatches includes the combined HCPCS code for each item, shown next to the service level. (If you don't see these codes listed for your dispatches, then you need to edit your Facility records and set their HCPCS codes.) The combined HCPCS code makes it easy to tell the difference between an outbound trip (e.g. NH) and the return trip (HN), which is otherwise difficult to tell just by looking at a typical EOB.

Recording the Event

Click the Dollar sign button to record a payment event for the selected dispatch. A new window opens to collect the relevant information from you. This window is reused every time you click the button to record a payment event, so if you are processing several payment events (e.g. inputting a combined EOB statement for several patients), leave the new window open and over to the side, so that you can switch back and forth between it and the Record a Payment Event page.

You can enter any or all of the following pieces of data, or leave them blank:

Once entered, click 'Save'. The window then changes to an acknowledgement screen, showing a table of all recorded payment events for the dispatch. Use the table to check your work before proceeding.

The "Next Steps" Decision

Many payment events will trigger a change to the dispatch's Postprocess Status, or to its Payor, or both. Here are the most common situations requiring a change:

Insurance Pays, Copay Still Due

When the received payment covers the insurer obligation and all that remains is the copay, then move the dispatch to 'Billing Office' and change the payor to 'Patient'. This will cause the dispatch's remaining balance due to show up on the next batch of patient invoices.

Workflow loops

The Invoice Generator for Patients will then push the dispatch forward to 'Awaiting Payment' once the proper invoice is generated and committed. (further reading)

Insurance Pays, No Copay Due

When the received payment covers the entire balance due (e.g. patient has no copay), then move the dispatch to 'Finished'.

Workflow loops

Insurance Denial

When denied by insurance and in need of resubmission to the insurance company or to a different insurance company, then move the dispatch to 'Billing Office'. It will then appear in the Insurance Appeal Queue.

Workflow loops

Insurance Final Denial, Bill to Facility

When denied by insurance and therefore the responsibility of the facility, then move the dispatch to 'Billing Office' and change the payor to 'Facility'. This will cause the dispatch's remaining balance due to show up on the facility's next invoice.

Workflow loops

Insurance Final Denial, Bill to Patient

When denied by insurance and therefore the responsibility of the patient, then move the dispatch to 'Billing Office' and change the payor to 'Patient'. This will cause the dispatch's remaining balance due to show up on the patient's next invoice.

Workflow loops

Full Cash Payment

When processing a full cash payment from a patient, simply push the dispatch forward to 'Finished'.

Workflow loops

Remember that when cash-pay dispatches graduate QA (or skip it), they advance immediately to 'Awaiting Payment'. They do not stop at the billing office first; rather, they assume the driver has already collected the money and will turn it in at the station for processing. (further reading)

Partial Cash Payment

When processing a partial cash payment from a patient, and the payment does not cover the entire balance due, then move the dispatch to 'Billing Office' if you want to re-invoice the patient for the remainder:

Workflow loops

If, on the other hand, you plan to simply wait for the patient to send in the balance, then leave the dispatch at 'Awaiting Payment'.

Write Off the Balance Due

When you give up attempting to get paid for the dispatch, you can write it off by simply moving it to 'Finished'. Its uncollected balance will thereafter show up in AngelTrack's tax reports.

Workflow loops

You can do this at any time, regardless of what billing activity has already been done. And you can always record additional payments, or move it back to 'Billing Office', whenever you wish. The only requirement for advancing a dispatch to 'Finished' is that it must have a price quote. The price quote is used to calculate the tax writeoff. To learn more about tax calculations, read the Taxes and Collections guide.

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