Work with Insurance Payments
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Important: This section is for entering and allocating insurance payments manually in axiUm. To handle insurance payments automatically, see Manage EDI Remittances. Patients that have insurance coverage do not generally have to pay the entire cost of their treatment because their insurance company often covers part or all of the cost. After services have been rendered to a policy holder or their dependent and submitted within a claim, the insurance company sends back payments for the charges, usually in the form of a check, to pay for their portion of these charges. They also send an Explanation of Benefits (EOB) document, outlining how much money should be applied to each treatment. Note: A claim may contain one or multiple treatments for a single patient. Important: Even though the full charge amount is sent to an insurance company on a claim, the company may pay a partial amount or no amount at all. The EOB will be used to allocate the insurance payment to the correct treatments in the correct amounts. Examples: The coverage template is out of date or the insurance limits were reached. Insurance companies entered in axiUm may be parent or child companies. A parent company is a larger company that is a collection of child companies. You can submit claims only to child companies, but you may receive payments from parent companies. Important: Claims cannot be submitted to a parent insurance company. Only child insurance companies are set up as actual insurance companies. To expedite the payment process, insurance companies usually send a payment for multiple claims and multiple patients. These are called bulk insurance payments. An insurance payment is handled the same regardless of how many patients and treatments are included on a single payment. The Ins Pmt tab allows you to enter insurance payments into axiUm and allocate them as necessary. The lower tabs display the insurance payments entered into axiUm for the selected insurance company. Allocation identifies which patient record the payment will be applied to as well as which treatment/charges. Example: An insurance company may make a payment that is then split between several different patient records. Once entered, insurance payments must be allocated to completed treatments. Records may display in different colored text based on their status in the Ins Pmt tab:
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