PERMISSIONS REQUIRED: You need the Billing permission to work with remits.
When you receive electronic remits from a payer through the system, you can review the payments that were made and then finalize each claim to the next payer or to the billing account.
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Review the Remit
Start by reviewing the payments and adjustments made to each claim to make sure they were paid as you would expect.
- Go to Billing > Remittances > Received to see the list of remits your clinic has received.
TIP: You can tell that a remit came in electronically if the View File icon to the right has a lightning bolt.
- Click a remit to see the claims linked to it.
NOTE: If you find a problem, you can correct and resubmit the claim.
Finalize the Claims
If you are satisfied with how a claim was paid, you can finalize it to the next payer or to the patient's billing account. The Next Step column indicates which of these will happen when you finalize each claim from the remit.
- Finalizing to the next payer creates a new instance of the claim that can be sent to that payer.
- Finalizing to a billing account adds the total of any Patient Responsibility adjustments to the account's statement as a charge.
TIP: Choose Where to Finalize - If the current payer did not assign any patient responsibility, the system will skip the remaining payers by default. If you want to choose whether to finalize a claim to the next payer or to the patient's billing account, you can finalize it from the claim form instead.
To finalize the claims on a remit:
- From the list of claims linked to a remit, select the checkbox next to one or more claims.
- In the lower right, click the Finalize button.
- To confirm that you want to finalize the selected claims, click the Finalize Adjudications button.
NOTE: Out of Balance? If a claim has a red icon next to it, then too much or not enough of the submitted charges have been allocated on remits. You will need to balance the claim before it can be finalized.