Sometimes you bill one amount to the insurer, but the amount paid is less than what you billed.
This might be because the client’s coverage changed, or they maxed out their plan, or there was a clerical error, or one of the many, many, other reasons that insurance billing can be a bit complicated!
When you are underpaid there are two scenarios - the first is that you want to bill the amount that was not paid by the insurance company to the patient, the second is you want to write off the unpaid amount and not collect at all.
Adjusting the Eligible Amount
When you’ve billed more than what’s paid, we call the paid portion the Eligible Amount.
Before receiving any payments on the claim, you first need to adjust the amount covered by insurance within the Purchase window.
One of the best places to deal with multiple insurance claims is under Billing > Claim Submissions in the Submitted Area.
Click on the arrow to the far right of the claim and select View Purchase:
If you prefer working from a single patient’s profile, you can get to the same area under Patients > Billing > Purchases and click the View button to open the purchase:
In the Purchase window that opens, scroll down to the Insurance section. Here you can set the Eligible Amount field to the amount being paid by insurance:
Billing Unpaid Amount Back to Patient
If there is a user fee or gap payment you’d like to see covered by the patient, you can enter this amount into the User Fee field:
- *Please note that Jane will inherit the tax settings from the treatment. If your treatments are taxable, set the pre-taxed amount to be billed to the patient.
Paying the Insured Portion
Once you’ve updated the eligible amount, scroll to the top of the Purchase and select the arrow beside the Pay button:
Receive the insurer payment.
Help! I can’t edit the Eligible Amount
If your insurance claim is greyed out and unresponsive, chances are you can’t get past the first step of editing the eligible amount.
There are couple of reasons you wouldn’t be able to modify the insurance claim:
Payments Applied Jane will not allow you to modify claims with payments applied, so first Unapply any payments applied to the insurance claim. Unapplying an Insurance Payment
Grouped Invoices If you had grouped together multiple invoices before submitting them to insurance, you will need to ungroup them to make any changes. You can follow these steps for grouping and ungrouping invoices: Grouping and Ungrouping Invoices
If you’re having any other workflows you’re trying to act out, or have questions not answered by the guide don’t hesitate to reach out to us at email@example.com