How do I know when to record my pending payment
If you are in Canada and waiting for a response or payment from an insurance provider, you could be in limbo and unsure of when to record a pending payment against a patient.
Its important to note that the patients balance should be the amount you are ready to collect from them. If you are unsure on how much the insurance provider will pay out you should move the patient balance to the insurance balance, until you are confident how much to collect.
Let's take a look at a few different scenarios, and when you should be recording that pending payment in each:
Submit a claim with only primary insurance
Get an immediate EOB response: a pending payment will auto-create so any remaining patient balance will be ready to collect.
Get an Ack/manual submission: record a pending payment for the full invoice amount. When insurance pays, any remaining amount will move to the patient balance for collection - see claims management.
Submit a claim with primary and secondary insurance
Primary EOB & Secondary EOB: a pending payment will auto-create for each insurance so any remaining patient balance is ready to collect.
Primary EOB & Secondary Ack/manual: a pending payment will auto-create for primary. Record a pending payment for remaining amount. When secondary payment received, the remaining amount will move to the patient balance which is ready to collect.
Primary Ack/manual & Secondary Ack/manual: pending payments are not auto created. Record a single pending payment for the full amount. When primary is paid, record a pending payment for the secondary. Submit the secondary and when that is paid reconcile and then collect any remaining patient balance.
For help on how to record a pending payment take a read of our handy help guide here.