Question - How to Finalize Supplemental Payments

[dr4com4lfoy]

Good Day,

I have a question on how to finalize supplemental payments. I'm currently handling additional payments to claims that were already received and attached to a batch payment. These are sent to us using EOBs so I need to attach them to a payment and upload the EOB.

Here's what I have in mind:

1. Use ClaimProcs POST Supplemental to create supplemental payments to procedures.
2. Use ClaimPayments POST Batch to create a claim payment using a blank array [] for the claimNums with the CheckAmt matching the total of supplemental payments.
3. Attach the ClaimPaymentNum to procedures using ClaimProcs PUT.

I doubt ClaimPayments POST Batch allows a blank array on the claimNums so I hope you enlighten me with this one.

Thank you.

[JTS]

Good morning,

ClaimPayments POST Batch does not support using a blank array for claimNums. It does, however, support passing in a ClaimNum for a Claim that already has an insurance payment.
What this means is that, for Claims already received and attached to a batch payment, you can add additional supplemental payments to the claim with ClaimProcs POST Supplemental, and then call ClaimPayment POST Batch on that same claim to finalize any Supplemental payments. This workflow matches the one found here: https://www.opendental.com/help252/clai ... %20Payment

So essentially, just the first two steps you've outlined in your post, except passing in the ClaimNum rather than a blank array.

Thanks!

[dr4com4lfoy]

Good Day,

We have an issue when applying supplemental payments using the API.

These were our steps:
1. ClaimProcs PUT to update the write-off.
2. ClaimProcs POST Supplemental to create supplemental payment.
3. ClaimPayment POST Batch to finalize the payment.

On one of the claims that were processed using the API it seems the supplemental was created and added to a batch payment with the Ins Pay Total calculated to 206.40.

supplemental-issue-1.jpg (121.57 KiB) Viewed 3015 times

But when we go the patient account module the payment amount is not updated (still 206).

supplemental-issue-2.jpg (11.41 KiB) Viewed 3015 times

The payment amount is also not updated when I used the Claims GET.

api-amount.PNG (1.84 KiB) Viewed 3015 times

I'll also attach a sample of a supplemental payment that was processed manually displaying the correct updated values.

supplemental-sample-1.jpg (64.11 KiB) Viewed 3015 times

supplemental-sample-2.jpg (8.88 KiB) Viewed 3015 times

I hope you can enlighten me with this one.

Thank you.

Allen

[JTS]

After looking into and duplicating the issue on my end, I've determined that ClaimProcs POST Supplemental does not currently update the InsPayAmt of the Claim being attached to in the same way that the UI does. We'll look into fixing that up.

As a temporary fix in the meantime, successfully calling ClaimProcs PUT on a ClaimProc attached to the same Claim will correctly update the Claim's InsPayAmt field.

Thank you for reaching out.

[dr4com4lfoy]

Good Day,

Thank you so much for the reply! For now I changed our steps to:

1. ClaimProcs POST Supplemental to create supplemental payment.
2. ClaimProcs PUT to update the write-off.
3. ClaimPayment POST Batch to finalize the payment.

With this setup Step 2 will trigger the event that updates the InsPayAmt after creating a Supplemental Payment.

Allen

[JTS]

Good morning,

As of version 25.2.50, ClaimProcs POST Supplemental will now update the InsPayAmt of the Claim being attached to. Since ClaimProcs POST Supplemental only returns the ClaimProc, you'll need to use Claims GET in order to view the updated InsPayAmt afterwards.

Let us know if you have any further questions. Thanks!