Posting EOBs

For any payers that do not support the transmission of ERAs, you will receive paper EOBs to your office. Those EOBs must be posted in EZDERM to reflect that insurance payment in the patient's account. The claim will sit in the status Pending Insurance until the insurance payment information is posted in EZDERM.

If you are receiving paper EOBs and would like us to enroll you for ERAs for a certain payer, email enrollment@ezderm.com with the Payer ID and we will be happy to get the process started if that payer supports ERA transactions.

TO POST AN EOB:

Step 1: Add a new Insurance Payment. Go to Payments on the left-hand menu and click "Add Insurance Payment" in the upper right-hand corner.

Step 2: Select a claim. Use the "Claim Search" field to find the claim that this EOB is tied to (the EZ number should be on the EOB). You will be able to add additional claims to this EOB on the next screen, so if there is more than one claim on this EOB, just select one claim for now.

Step 3: Enter in the Payments Details, such as the date insurance paid, how insurance paid you (Transaction Type), and how much was paid. It is important to note that the Payment Amount field should be the Total Check Amount if there is more than one claim on the EOB.

Step 4: Click Post in the bottom right-hand corner.

Step 5: Use the blue "Insert New Claims" button on the right-hand side of the claim list if you need to add additional claims to this EOB. If the claim you are looking for does not appear, please ensure that the responsibility for that claim is on the payer the EOB came back from, not on the patient. If the responsibility is on a different payer, use the filter icon on the right-hand side of the screen to filter for claims pending with all payers.

Step 6: Fill in the CPT Payments information. Open the first claim and in the CPT Payments section, manually key in the Allowed, Deductible, Co-Insurance, Copay, Paid, and Adjusted amounts. It is important to enter these values from left to right or else you will receive a claim balancing error (the Paid amount plus the patient responsibility should equal the Allowed amount). It is also important that these fields match the EOB exactly. If you make a mistake or need to enter in these fields from scratch, you can either zero out all fields, or you can click Cancel in the bottom left-hand corner, open the claim and start again.

Step 7: Apply any Unapplied Patient Payments. Once those amounts are entered into the CPT Payments section, the Balance remaining should reflect the patient responsibility noted on the EOB. For example, if on the EOB the patient responsibility is $35 for their copay and $25 as a deductible for a procedure, the balance remaining should be $60. If the front desk collected some or all of this responsibility up front and linked the patient payment to the Date of Service, you will see that patient payment available in the Unapplied Patient Payments section in orange. Click the orange Auto-Post button to apply that unapplied patient payment, thus bringing the balance of the claim down. For example, if the balance is $60 and the front desk collected the copay up front, you will see $35 of unapplied patient payments available to you in orange. When you click Auto-Post the balance will come down to $25 for the remaining balance (the deductible amount for the procedure not collected up front).

Step 8: Update the claim Responsibility to the secondary/tertiary payer or to the patient depending on where the claim is in its lifecycle. Once the Responsibility is changed, the claim status will update according to the following principles:

• Ready for Electronic Submission: There is a remaining balance on the claim, the patient has secondary/tertiary insurance, the primary has not forwarded the claim to the secondary/tertiary, the secondary/tertiary insurance has a payer ID in the system.
• Ready to Print: There is a remaining balance on the claim, the patient has secondary/tertiary insurance, the primary has not forwarded the claim to the secondary/tertiary, the secondary/tertiary insurance does not have a payer ID in the system.
• Ready for Patient: There is a remaining balance on the claim and the patient does not have any secondary/tertiary insurance.
• Complete: There is no remaining balance on the claim.

Step 9: Leave a Statement Note for the patient if there is a remaining balance and the responsibility is now on the patient. This message will appear on the statement sent to the patient.

Tips:

• Click on the patient's name in the "Payment Info" section at the top to go directly to the patient's chart. 
• Click on the Claim Number in the "Payment Info" section at the top to go into the claim itself.
• Use the Claim Note field to view or leave any internal notes regarding the claim.
• You can add a patient adjustment in the Adjustments section. Click "Settle" to automatically create an adjustment for the remaining balance.