Batch Claim Payments 835

The Electronic Remittance Advice (ERA) or 835, is the electronic insurance transaction which provides claim payment information in the HIPAA mandated format. These files are used by dental practices to post claim payments using QSIDental Web.

Batch Insurance Payments - 835 Overview

QSIDental Web’s Batch Insurance Payment -835 module summarizes the 835 information received from carriers by associating it with check and deposit information received from banks and claims processed in QSIDental Web. Payments may be easily posted to patients’ accounts. Utilization of QSIDental’s Electronic Data Interchange (EDI) is required.

The 835 Posting tool is located under the Transactions menu.

The Batch Insurance Payment - 835 module utilizes electronic files and the QSIDental Web files to streamline and support the posting of insurance claim payments to patient accounts. In QSIDental Web, many of the 835 and payment processing and posting tasks may be automated through overnight processes and the Task Scheduler; however, they may also be performed manually.

To post payments from 835 files using the Batch Insurance Payment - 835 module, the following items are required:

an 835 file supplied by EDI
a file from the bank containing deposit information, and
QSIDental Web claim information.

The 835 data typically contains details of payments for one or more claims, claim level remittance and adjustment information, and/or responses to preauthorization requests. The bank file contains details of payments such as check number and amount and is crucial for determining what deposits have been received.

The claims represented by the 835 files and the bank files are matched with claims processed through QSIDental Web and displayed in the Batch Insurance Payment - 835 module. The module offers four tabs for viewing and managing insurance claim items, associated 835s and payments, adjustments, preauthorization information, and deposits. The tabs are:

Payments: Display payments that meet the criteria selected via radio button.

Pre-Auth Remittance: Display all notifications that were received in context of preauthorization requests and would not have associated payments.

Provider Adjustments: Display all payments that have provider adjustments and meet the criteria selected via radio button.

Checks: Display all checks that have and have not been deposited.

Deposits: Display those payments that have been received by the bank but for which no associated 835 has been received.

Batch Claim Payment Search Option

An individual payment may be located using the Search tool. This robust tool can be used to search for a payment by pay date, carrier name, check number, EFT Trace number, or payment amount within the selected tab. To locate a payment:

Type the search string in the field. (There is no need to select a search criteria; the tool will compare the string to the relevant field.)

Click the Search button.

To restore the original list and remove the search criteria, click the X in the search field.

Processing Batch 835 Payments

To complete the process, checks that have been deposited and can be directly tied to a claim in QSIDental Web need to be posted to the patients’ accounts. Those checks that cannot be tied to a claim, called unresolved payments, must be reviewed and managed. Claims that are missing payments need to be researched.

To determine which checks have been deposited, a bank file containing deposit information must be loaded into QSIDental Web. This .csv file comes directly from the bank and provides the important information about when and how payments have been received. Please contact a QSIDental support representative for more details.

Posting payments to patient accounts can be accomplished via the Batch Insurance Payments-835 module or using the 835 Auto Posting task in the Task Scheduler. When using this automated tool, payments and applicable adjustments will be automatically posted into the patients’ ledgers based on established settings and a summary report delivered to the user (See Task Scheduler for more details).

Post Payments Automatically

When payments are not posted via the Task Scheduler, they must be processed and posted within the Batch Insurance Payments-835 module. Only payments that can be matched to a claim in QSIDental Web and that have been deposited, may be posted using this automated process. Unresolved and failed payments must be posted manually. For more information, see Post Payments Manually.

To post payments through the Batch Insurance Payments-835 module:

Upload the bank file. For more information, seeSee Upload Data.
Open the Batch Insurance Payments-835 module.
The EDI 835 data and bank file data are displayed in the Payments tab. For more information, see Payments Tab .
Select the desired payment by selecting the check box beside the payment, or select the check box at the top of the column to select all.
Optional: Review and audit selected payments. For more information, see Audit Payments.
1. Load claims for selected payments to drill deeper into claim details.
2. Click Audit selected payments.
3. Review and validate the claims, checks and payments.
Select the date to be used as the posting date. The date may be selected from any date since the last closing date up to and including the current date. Future dates may not be selected.
Click Post selected payments .
Reconcile the posting using the Payments Details Report and the details within the patient’s Ledger. For more information, see Payments Details Report
- Account Ledger

ERA Audit Reports

ERA Audit Reports are useful to preview payments prior to posting them to the patient accounts.

The Detail Report displays each line item’s information in the PAYMENTS AND ADJUSTMENT POSTED section. The Comment section includes the status of the claim, and messages as applicable. For more information, see Partial Payment Status.

The reports are divided into three sections which include payments that will not be posted or rejections, payments that will be posted, and provider adjustments. Click Audit selected payments button, and choose Summary Report or Detail Report. Click Generate Report to create and view the report.

The following table describes the sections in the ERA audit report.


Section	Description
Rejected Claims	Check Information. Patient Information. Claims and services details. Reasons for rejection, audit messages.
Payments and Adjustments Posted	Check Information. Patient Information. Claims and services details, including payment and adjustment amounts, and claim status. Reason for the partial status and audit messages as applicable. For more information, see Partial Payment Status.
Provider Adjustments	Check Information. Provider adjustment details.
Totals	Total processed amounts including rejected, posted, and adjusted.

Payments Details Report

Payments Details Reports are used to reconcile payments posted automatically in the Batch Insurance Payments-835 module.

This report is available after the selected checks are processed, and the payments are posted.

The Payments Details Report provide the same information as the ERA Audit Report. The Detail Report displays each line item’s information in the PAYMENTS AND ADJUSTMENT POSTED section. The Comment section includes the status of the claim, and messages as applicable. For more information about partial payments, see Partial Payment Status.

Click the Posting Report button, and select Summary Report or Detail Report. Click Generate Report to create and view the report.

Note: Payment Details Report can be generated only once and is available to the user that posted the specific payment.

Audit Messages

Audit messages may display for various reasons on posting payments for a given claim.

You can view the audit messages in the Comment section in ERA Audit Report and Payments Details Report.

The following table describes the conditions which cause audit messages may be displayed for a claim.


Claim Adjustment Method on ERA Profile	Audit Messages	Reason
Billed vs Allowed	Adjustments not posted	Displayed if a given claim has adjustments which are not posted. These payments may not be posted due to various reasons, for instance when only a portion of the QDW claim is included in the ERA file.
Billed vs Allowed	Allowed more than billed	Displayed if the allowed amount reported in the ERA file is greater than the QDW billed amount.
All	Billed to secondary	Displayed if the payment was billed to the secondary insurance carrier by the ERA process.
All	Billed to tertiary	Displayed if the payment was billed to the tertiary insurance carrier by the ERA process.
All	Billed to Quaternary	Displayed if the payment was billed to the quaternary insurance carrier by the ERA process.
All	Claim level adjustment	Displayed if there is an ERA adjustment code included at the claim level. It is usually a deductible amount but can also be any valid adjustment code.
All	Claim level reason code adjustment	Displayed if there is an ERA adjustment code included in the ERA profile’s Reason Code Needing Review list.
All	Claim variance exceeded	Displayed if the amount received for claim in the 835 file is less or more than the amount expected based on the threshold variance set in the Claim Variance Allowed field in the ERA Profile.
From Remaining Expected	Deductible Mismatch	Displayed if the deductible in the 835 file is greater than zero, and does not match the QDW deductible value for the claim.
Billed vs Allowed, From Remaining Expected	Dual Coverage-Final Payment	Displayed if the payment is from the final insurance carrier, and the Dual coverage adjustment option in the ERA Profile is set to No adjustment, leave partially paid.
All	Line item denied	Displayed if a line item is paid $0, and it Does not have any Contractual Obligation(CO). Is not fully Patient Responsibility (PR).
All	Line item variance exceeded	Displayed if the amount received for a line item for a claim in the 835 file is less or more than the amount expected based on the threshold variance set in the Line Variance Allowed field in the ERA Profile.
Billed vs Allowed	Other adjustments may apply	Displayed if the difference between the billed amount and Contractual Obligation (CO) is not equal to the sum of the paid amount and patient responsibility.
All	Warning: possible double adjustment	Displayed if an adjustment was posted to a secondary, tertiary or quaternary claim by the ERA process.
All	Reason code needing review	Displayed if a reason code included in the ERA file at the service level is in the ERA profile’s Reason Code Needing Review list.

Partial Payment Status

View the partial payment status in the comments field of the ERA reports.

A partial status is assigned to a claim for several reasons. The Comment field in the PAYMENTS AND ADJUSTMENTS POSTED section of the ERA reports displays the partial status and the reasons for assigning it to a claim.

Reasons for Partial Payment Messages

There are various reasons for which a partial status is assigned to a claim.

The following table describes the reasons for which a partial status is assigned to a claim.


Claim Adjustment Method	Partial Payment Message	Reason
Billed vs Allowed	Missing primary 835	Displayed if the payment is from the final insurance carrier, and the primary insurance payment was not paid through ERA.
Billed vs Allowed	Allowed more than billed	Displayed if the allowed amount reported in the ERA file is greater than the QDW billed amount.
Billed vs Allowed and From Remaining Expected	Dual coverage profile option	Displayed if the payment is from the final insurance carrier, and the Dual coverage adjustment option in the ERA Profile is set to No adjustment, leave partially paid.
From Remaining Expected	Deductible mismatch	Displayed if the deductible in the 835 file is greater than zero and does not match the QDW deductible value for the claim.
From File	Contractual RCNR (<codes>)	Displayed if one or more reason codes are Contractual Obligations (CO) and included in the Reason Code Needing Review (RCNR) list in the ERA Profile.
From File	Pat Resp RCNR (<codes> )	Displayed if a line item is paid $0, and: One or more reason codes are Patient Responsibility (PR) included in the Reason Code Needing Review (RCNR) list in the ERA Profile. The service line has no Contractual Obligation (CO).
All	Line item denied	Displayed if a line item is paid $0, and: Does not has any Contractual Obligation (CO). Is not fully Patient Responsibility (PR).
All	Claim denied	Displayed if the claim is denied and the Close Denied Claims option in ERA Profile is set to NO.
All	Line item not in 835: (Dxxxx, Dxxxx)	Displayed when not all service lines of a QDW claim are received from the carrier in the 835.The services missing from the 835 file are listed in the Comment column.
All	Claim level contractual adj (CO<code>)	Displayed if there is a Contractual Obligation (CO) reported at the claim level.
All	Claim level RCNR (<codes>)	Displayed if there is a claim level adjustment that is included in the ERA profile’s Reason Code Needing Review list.
All	Claim variance exceeded	Displayed if the amount received for a claim in the 835 file is less or more than the amount expected based on the set threshold. The claim threshold variance is set in the Claim Variance Allowed field in ERA Profile.
All	Line item variance exceeded	Displayed if the amount received for a line item for a claim in the 835 file is less or more than the amount expected based on the set threshold. The line threshold variance is set in the Line Variance Allowed field in ERA Profile.

Post Payments Manually

Checks with payments that do not match a claim in QSIDental Web are identified as Unresolved. Those payments must be posted manually. Additionally, if a payment fails to post using the automatic process, the payment must be posted manually. If the payment does not match a QSIDental Web claim because of the patient and claim combination, the patient must be determined first.

To manually post an insurance payment (See Insurance Payment for more information):

Click on the hyperlinked check number to open the check details.
If the claim is unresolved, first select the Unresolved Claims radio button and if the claim did not post for some other reason, select the All Checks radio button.
Click the View EOB Details button. Keep the EOB screen open as a reference or print it if desired.
Select Insurance Payment from the Transaction menu to open the Insurance Payment module.
Enter the payment details as appropriate.
Select the desired claim for the patient.
Click the Browse (…) button button to locate the check number.
Enter the check details in the Insurance Payment section from the EOB Details.
Enter the payment information for each treatment in the claim based on the EOB Details.
Select the Close Claim check box if the carrier considers the claim paid in full.
Click the Apply button.
Select Batch Insurance Payment -835 from the Transactions menu to return to the module.
Select the radio button beside Unresolved.
Select the recently posted item(s) and click the Remove selected payments button.

Note: This only applies if the claim was unresolved due to a ClaimUID issue. To have the EOB associated with the claim for payments with ClaimUID issues, print the EOB data, scan it and the associated EOB at the time payment is posted.

Upload Bank Data

For claims to be matched with deposits, the deposit data must be brought into QSIDental Web. The data may be imported in a variety of ways, depending on the subscription options selected by the practice. Data can be easily imported using the File Upload Utility.

To import payment data:

Select File Upload Utility from the Utilities menu.
Select the type file to be uploaded and click the Open button.
- Bank File: Deposit data from the practice’s bank displaying the funds received with the check/EFT number. This information populates details in the Batch Insurance Payment - 835 module. The file must be in CSV format and no larger than four megabytes.
- 835 File: ERA data explaining what is being paid with adjustment reason codes and other information. Typically, this information is already imported by QUIC and will not need to be manually uploaded. The file must be a .dat, .txt, or .835 type and no larger than eight megabytes.
Click the Upload and Post Payment button. Please note that the button actually just uploads the file and will not post the payments.

Once the file has uploaded, a message will appear at the top of the window. This indicates the bank’s payment data is now visible in the Batch Insurance Payment – 835 module. Checks that match an 835 check in the system will display with a check mark in the Deposited column of the Payments tab indicating it has be deposited and is available for auto-posting. If the check does not match an existing check, it displays on the Deposits tab.

Audit Payments

Many practices prefer to audit some or all of the pending payments prior to posting them to the patient accounts.

The Payment tab of the Batch Insurance Payments – 835 module has a variety of tools to drill into payment, claim and EOB data for auditing and analyzing payments.

The Load claims for selected payments button opens a window displaying the claims associated with the selected payments.

Click Detail to display more information about a claim ().
Click () to return to the Payment screen.
Click Detail to display specific details about a claim, its associated procedures, and payments.

Note: A checkmark in the Reasons column indicates that a reason code is associated with the check.
Click … in the Reasons column to view specific reason codes.
Click View EOB Details to view details about EOB specifics.

Note: In addition to the linked 835 and EOB information, you can generate ERA Audit reports for online use, saving, or printing by clicking Audit selected payments. For more information, see ERA Audit Reports.

Unresolved Items

A check is considered unresolved when all or part of the check cannot be matched to a claim in QSIDental Web. Clicking the radio button beside Unresolved on the Payments tab displays these checks. The reason the check cannot be matched to a claim displays in the Unresolved column:

ClaimUID: The patient and claim combination from the 835 file could not be matched to a claim on the QDW system.
Service: One or more of the services (charges/line items) on the claim cannot be matched to the corresponding claim in QSIDental Web.
Bad Data: The 835 data contains that does not match one of the categories. For example, carrier indicates pre-auth, but the claim ID matches a valid claim.
ProviderID: The provider ID in the 835 does not correspond to any provider ID associated with the claim.

Note: If none of the claims on the check can be matched, the check will only display with the Unresolved filter. If the check represents both claims that could be matched and claims that could not be matched, the check will display with both the All checks filter and the Unresolved filter.

Payments Tab

The Payments tab displays the 835 and check information. The radio button filters include:

All Checks: Display all checks that match claims within QSIDental Web, including checks that have been deposited at the bank and those that are anticipated based on the 835 file (Both Checks Deposited and Checks Not Deposited). Closed or Force Closed checks will not display.
Unresolved Claims: Display checks, either deposited or not, that do not match a claim in QSIDental Web. This includes Closed or Forced Closed checks.

Use the Search field to search by any of the available fields.

The Payments tab displays the details for the check, depending on the radio button selected to filter the list.

P-ID: The Claim Header Identifier for the check.
Pay Date: The date of the check as indicated by the carrier.
Check Status: The status of the posting of the specific check. Click the hyperlinked check number to see the specific posting details for each claim covered by the check.
- New: A check that has just appeared in the list.
- Not Posted: A check that has not posted to any claims.
- Partial: Part of the check has posted to one or more claims. Please note that once a check is fully posted, it will be removed from the list.
Payer Name: Carrier that issued the check as indicated in the 835 file.
Check#/EFT Trace#: If the payment was a check, the check number displays; if payment was made using an electronic funds transfer (EFT), the EFT number displays. This identifier number is set up as a hyperlink and when clicked opens the Matched Payments window identifying all claims associated with the payment. It can be used to identify and evaluate allocations made.

The Matched Payments window displays the following:
- The top section displays the check details, including payer, check number, date, and amount.
- The center section displays the claims paid by the check.
- The bottom section displays the specific line item details from ledger for the selected claim
- There is a section that displays provider adjustment details which is a sum of the PLB for the check and can be found via the Batch Insurance Payment-835 screen or Provider Adjustment screen. The details can be viewed by clicking the arrow button.
- Clicking the View EOB Details button shows the EOB detail associated with the selected claim.
Deposited: Indicates whether a check or EFT payment was received and matches the selection made by the radio button.
Note: A checkmark indicates that the payment details in the 835 match the payment details in the check. An exclamation point indicates the 835 details do not correspond to any check or EFT details.
Check Amount: The total amount of the check as indicated in the 835 file.
Post Amt.: The amount of the indicated check that has been posted to the claims represented by the check. Once the total payable amount is posted, the check is removed from the list.
- A dollar amount less than the full check amount indicates that part of the payment was posted and the other part was held back. Review the ERA reports to determine the status of a payment.
- If the amount displays as $0.00, then no attempt to post has been made or all claims represented by the check were denied or failed to post.
Rem To Post: The amount of the check that still needs to be posted (Pay Amt – Posted Amt)
Type: Displays the mode of payment :
- ACH: Funds were received via EFT
- CHK: Funds were received via a paper check
- FWT: Funds were received via Federal Reserve Funds or Wire Transfer.
- NON: The check amount was $0 indicating claim payment, takebacks or adjustments, or preauthorization responses.
Resolve Claims: This is set up as a hyperlink and when clicked, will open a Resolve Claims window.

Pre-Auth Remittance Tab

The Pre-Auth Remittance tab displays all responses to pre-authorization requests that accompany 835 data. These responses would not have associated payments.

Recent responses to pre-authorization requests are displayed in the tab with details for each. The details include:


Pre-authorization Request Fields	Description
Claim ID	The ID associated with the original Preauthorization claim. This number serves as a link back to the request.
Confirmation Date	The date of the preauthorization request .
Carrier Name	The name of the carrier returning the response.
Patient Name	The name of the patient.
Fee	The fee to be billed for the procedure(s).
Est Ins	The expected amount to be paid by the carrier for the procedures.
Ins Allowed	The amount the carrier will pay according to the preauthorization response.
Status	The status of the request.
View EOB	View the details of the preauthorization response in an EOB format.

Provider Adjustments Tab

Payments may include some specialized adjustments which are made at the provider level and are independent of specific treatments or claims. These adjustments may increase or decrease the amount paid on a check. While the adjustment is not always associated with a specific claim in the 835, they are used to balance the transactions. Possible provider adjustments include:

Increased payment for a provider incentive plan
Increased payment from interest from a late payment
Increased payment for a loan repayment
Reduced payment because of a prior overpayment

The Provider Adjustments tab displays all checks that contain a provider adjustment and the details of each adjustment. While payments will still be posted for the corresponding claim and will not be held back, corresponding adjustments can be made.

The Provider Adjustments tab displays some details for the check, its associated payment, and the provider adjustment itself depending on the radio button selected to filter the list. The details include:


Provider Adjustment Fields	Description
P-ID	The Claim Header Identifier for the check.
Pay Date	The date of the payment.
Check#/EFT Trace #	If the adjustment payment was delivered as a check, the check number will display; if payment was made using an electronic funds transfer (EFT), the EFT number will display. This identifier number is setup as a hyperlink and when clicked, will open a window identifying all claims and line items associated with the payment. It can be used to identify and evaluate allocations made.

Table 1.
Matched Payment Fields	Description
Payer Name	Carrier that issued the adjustment.
Fiscal Period	The date which ends the provider’s fiscal period, according to the 835 file.
Deposited	Indicates whether a check/EFT payment was received. Displays as a checkmark or exclamation point to match the detail of the check from the imported deposit file.
Adjustment Description	A short summary of the reason for the adjustment.
Adjustment Amount	The amount of the adjustment for the identified issue.
Provider/ID	The provider associated with the adjustment. If the provider can be mapped to a provider in QSIDental Web, that provider number will display, if not, the provider number will display as indicated in the file.
Additional Reference ID	On occasion, the adjustment will be associated with a previously paid claim. In these cases, if the reference number provided can be tied to an existing claim within QSIDental Web, the patient number and name associated with that claim will display, if not, the reference number will display as indicated in the file.
Link button	Opens the Patient Claim Search window. From here, select one or more provider adjustments that are linked to a claim.
Remove Selected Adjustment button	Clicking this button removes the selected adjustments from the screen. Once the adjustment is removed it cannot be linked to a claim.

The items on this screen appear for information only. Increases or decreases must be manually applied in accordance with practice policies.

Note: When posting these adjustments, note the following:

Positive adjustment amounts decrease the total check amount.
Negative adjustment amounts increase the total check amount.

Checks Tab

The Checks tab displays all checks, up to the number of checks defined in the administrator setup, from newest to oldest. This includes open and closed checks. This tab can be sorted by each of the fields.

P-ID: Unique check identifier assigned by QSIDental Web.
Pay Date: The date of the payment. The date is determined or reported by the payer and is not guaranteed to be the deposit date.
Check Status:
- New: No payments have been automatically or manually posted for this check and the auto-posting process has not been attempted.
- Not Posted: A check that has been run through the auto-posting process but did not post or posted in the amount of $0.
- Partial: Part of the check has posted to one or more claims. Please note that once a check is fully posted, it will be removed from the list.
- Closed: Check is fully posted and automatically posted and closed by the system.
- Force Close: Check is manually closed by a user.
Payer Name: Carrier issuing the check.
Check#/EFT Trace #: If the adjustment payment was delivered as a check, the check number will display; if payment was made using an electronic funds transfer (EFT), the EFT number will display. This identifier number is setup as a hyperlink and when clicked, will open a window identifying all claims and line items associated with the payment. It can be used to identify and evaluate allocations made.
Check Amount: The total amount of the check as indicated in the 835 file.
Post Amt.: The amount of the indicated check that has been posted so far. Once the total payable amount is posted and all claims included for the check have been posted, the check will be removed from the list.

A dollar amount less than the full check amount indicates that part of the payment was posted and the other part not included. To determine why a payment was not posted, review the ERA reports.

If the amount displays as $0.00, either no attempt to post has yet been made or all claims represented by the check were denied or failed to post.

Rem To Post: The amount of the check that still needs to be posted (Pay Amt – Posted Amt)
Provider Adjustment: Sum of all provider adjustments for the check.
Total no. of claims: Total number of claims found in the check, includes resolved and unresolved and posted and unposted.
Payments Posted: Are confirmed to have posted either automatically or manually.
Unresolved: The number of claims from this check that are still listed on the Unresolved Claims screen.
Resolved-Not Posted: Number of checks that are resolved but not yet posted.

About Pending Review Checks

You can review the duplicated and out-of-balance checks on the Pending Review tab.

The Pending Review tab lists the ERA checks that are out of balance or appear to be duplicates of another check. You can review these checks to determine if they can be released for posting or processing or be archived. You cannot autopost checks in pending review status and they do not appear in the ERA reports unless the check P-ID number is used in the reporting criteria.

The filters include:

Checks Pending Review lists the ERA checks that are duplicated or are out of balance. These checks can be released or archived from this window. When you release a check, it is moved to the Payments and Checks windows, from where you can post it using the ERA process. Archived checks are removed from this window and are considered as checks that must not be posted.
Archived Checks lists the ERA checks that are archived from the Pending Review Checks window. If a check is incorrectly archived, you can release it by clicking Release.

The following are the fields on the Pending Review tab:

P-ID is the unique check identifier assigned by QDW.
Pay Date is the date of payment. This date is determined or reported by the payer and is not guaranteed to be the deposit date.
Payer Name is the carrier issuing the check.
Check#/EFT Trace # is an identifier nuber. If the adjustment payment was delivered as a check, then the check number is displayed. If the payment was made using an electronic funds transfer (EFT), then the EFT number is displayed. This identifier number is set up as a link, and clicking it opens a window that identifies all the claims and line items associated with the payment.
Check Amount is the total amount of the check as indicated in the 835 file.
Sum of Payments is the sum of the claim payments included in the 835 file.
Provider Adj is the sum of all provider adjustments for the check.
Type is the mode of payment.
- ACH are the funds received through EFT
- CHK are the funds received through a paper check
- FWT are the funds received through Federal Reserve Funds or wire transfer
- NON when the check amount is $0 indicating claim payment, takebacks or adjustments, or preauthorization responses
Review Reason:
- Duplicate Check when the primary check information for a non-zero dollar check is a duplicate of a check previously received for the PGID. Primary data includes Check#/EFT Tace#, Pay Date, Check Amount, and the Originating Company ID (found on the check details window).
- Out of Balance when the amount of the check does not match the payment details included with the check (check amount does not balance with the sum of payments and the provider adjustment).
- Duplicate Check/Out of Balance when the check meets both of these conditions.
- Duplicate Payments when the payment details as well as the Check#/EFT Trace# and multiple other primary check details are duplicates of the data in an existing check.
- Duplicate Payments/Out of Balance when the check meets both these conditions.
- EDI Duplicates When an exact copy of a file created by the EDI department is received. The checks contained in the received copy are moved directly to the Archived Checks window.
Compare Checks: This is available only for the duplicated checks and duplicated payments. The details of the check and payment for the pending review check and the original check are provided. You can compare the details of the check to determine if the check must be released for processing or archived. Click View EOB Details to view the explanation of benefit details for payments on both the duplicated and original checks in their respective sections.

Note: Normally, Original Check is not Pending Review, but it can be. To identify that both checks are Pending Review, (PR) is added to Original in the upper section of the Duplicate Check / Out of Balance window and (Pending Review) is added to Original Check in the lower section.

Deposits Tab

The Deposits tab focuses on the checks actually received at the practice’s bank but for which no 835 information has been received.

The details include:

Table 2.
Deposits tab fields	Descrption
Issue Date	The date the check was issued. Issue date must match within +/- the number of days setup for Threshold Days in Account Setup
Check Number/EFT Trace#	The check number associated with the check.
Payment Amount	The amount of the check.
Payer Name	The name of the carrier/payer.
Originating Company ID	The number associated with the payer in the Carrier Setup. This must be an exact match to the information in the uploaded bank data file, with the exception of leading zeros.
Bank File Date	The date the bank file was uploaded. Once the checks in the Deposits tab have been reviewed and managed according to practice policies, the checks may be selected and removed using the Remove Selected Deposits button.