How to handle insurance underpayment

[atd]

I have a situation where a couple of insurance companies have underpaid us for services. The issue is being resolved, so I am expecting an additional payment on the same claims and don't know how to enter this all properly. Here's what I've done so far and the problems I'm having.

- The insurance coverage PPO at 100% so there is no patient responsibility. I have a PPO fee schedule entered and the expected writeoff is calculated correctly.

- I entered the payment from the insurance company. I did not alter the writeoff amount because I want to leave the balance due since we're expecting additional payment. This showed the claim was paid and the balance was due by the patient. So, I changed the claim status back to "Sent".

-The claim now lists the payment received, the remaining ins payment pending, the writeoff and the est. patient portion as $0 (all amounts are correct). However, the InsEst at the top of the account module shows $0 and the balance due to the patient. Is this a bug or did I do something wrong?

- When the second payment comes in I'm assuming I enter a supplemental payment, right?

[jordansparks]

It's in an inconsistent state. It's not designed to be "sent" with payments attached. That doesn't seem possible. So I wouldn't call it a bug.

It doesn't look like there's a built-in mechanism to handle further expected payments other than by setting up an "insurance" payment plan. That option might actually work. It's typically used in ortho offices to handle multiple payments on single procedures. When the payment comes in, get rid of the payment plan.

[atd]

It's in an inconsistent state. It's not designed to be "sent" with payments attached.

It almost works as expected though. The claim calculations are all correct, it's just the patient balance calculation that is off. Seems like it wouldn't be too difficult to correct, but I could be wrong.

I tried your suggestion on setting up an insurance payment plan, but that removes it from my accounts receivable report (even though it showed the payment was due). Our CFO wouldn't want that.

Can you better explain the supplemental payment procedures? This is all the manual says

Supplemental: Almost identical to Received. But indicates a second payment on the same procedure, much of the estimates will be 0.

The first time I came across this situation I changed the writeoff amount so there would be no patient balance, but changed the claim to Sent since I was resubmitting for the additional payment. Then when the second payment came in I entered a supplemental payment - but I couldn't do a negative writeoff (to "undo" the original writeoff we were now getting paid on), so I had to change the writeoff from the original payment first. Obviously this wasn't the right way of handling the situation.

Has anyone else had this issue? If so, what steps did you take?

[jordansparks]

A supplemental payment would be a second or third payment on the same procedure. There's not much more to it than that. Yeah, you can't enter negative writeoffs. Eventually, you will be able to "undo" writeoffs. They will actually go into the database as a second entry that doesn't affect the first entry. But that's just vaporware at the moment.