Batch Claim Payments

When insurance claim payments cannot be processed electronically, they can be manually entered into QSIDental Web. These insurance payments come from carriers in two ways:

In single checks representing a single claim for a single patient.
In a large batch check representing multiple claims for multiple patients.QSIDental Web has the capacity to process both.

The Batch Insurance Payment screen opens by selecting Batch Insurance Payment from the Transactions menu. The Batch Insurance Payment screen identifies the check, summarizes the claim information, and breaks down the claim into its component procedures. The top section focuses on the specific payment being entered.

The Batch Payment screen shares some characteristics with the single payment window. The main difference is that the insurance company needs to be identified first, instead of the patient.

Search Batch Checks

Batch checks cover multiple claims for multiple patients but come from a single carrier. To process the batch check, the first step is to locate the carrier. The tools to locate the carrier are on the right side of the Batch Insurance Payment screen.

Select By: Select the criteria to be used to locate the claims covered by the check by clicking the radio button beside the desired option.

Once selected, the available choices will display in the dropdown along with the criteria. The options are:

Carrier Name: Locate the claim(s) by searching by the name of the carrier that issued the check.
Provider Name: Locate the claim(s) by searching by the name of the provider indicated by the check or accompanying EOB.
Select Ins. Type: Narrow the list of search options by clicking the radio button beside the desired insurance type. The types are:
1. Dental Insurance: Filter the list for only Dental Carriers.
2. Medical Insurance: Filter the list for only Medical Carriers.
Search In: Narrow the search to claims within the current office or within all offices by clicking the radio button beside the desired location.The options are:
1. Current Office: Search for claims only within the office in which the user is currently logged on.
2. All Offices: Search for claims within any office in the practice.
3. Carrier/Provider: The label for this field depends on whether Carrier or Provider was chosen in the Select By section. The available options appear in the dropdown. Once a specific carrier or provider is chosen from the dropdown, the associated claims will appear in the middle section.

Batch Insurance Check Detail

In the Batch Insurance Check Detail section, add the details for the full batch check. These selections will impact the posting and record keeping. Details for an individual claim’s posting are handled in another section.

Check Amount : Enter the total amount of the check.
Check #

Enter the check number.
Click the Browse (…) button to look up the specific check within the list of all of the checks inserted into the database via an 835 process.
Check Rem. Amount (Check Remaining Amount): This is not an editable field; instead it is the calculation of the original check amount less the amounts already applied.The process cannot be completed until the amount is zero.
Bank #: Enter the Bank number, if desired.
Payment Type: Select the Payment Type from the dropdown. These payment types are established by the practice.
Disallow Type: If any portion of the claim is being disallowed, the adjustment can be automatically posted along with the payment. Select the adjustment type from the dropdown. These adjustment types are established by the practice.

Patient Insurance Payment

After the claims are loaded, portions of the check can be associated with specific patients and claims. Each allocation is managed using the Patient Insurance section and the selected insurance claim’s Details section.

Date: Payment date. Today’s date is entered by default.
Apply Amount: The total amount of payments applied to the claim. This figure is not entered manually, but is the cumulative total of payments entered.
Notes: Track any information desired by the practice.
Close Claim: The Close Claim check box sets the claim as closed and removes it from the outstanding claims list. The box is selected by default. If the claim is not to be closed because the payment is only partial and further payments are expected, clear the Close Claim check box to keep the claim open.
Adjustment: An adjustment entered in this section applies to the entire claim and is entered into the Ledger as a write-off using the adjustment type selected in the Disallow Type dropdown. Claim level write-offs are typically used when a small balance remains following insurance payment.

The amount of the write-off is entered and selected either as $ or as %, as deemed appropriate for the entry.

Write-offs and adjustments can also be linked to specific procedures by completing the disallowed amounts and reasons in the treatment for the claims section selected above. Usually, only one type of write-off is applied for a single claim.

Outstanding Insurance Claims

The outstanding claims for the carrier or provider is displayed at the center of the screen. The treatments associated with the selected claim display at the bottom.


Outstanding Insurance Claims	Desccription
Search	If the list of claims is extensive, you can locate a specific claim by searching for a specific patient by typing his/her first or last name and clicking the Search button. The full list of claims is restored by clicking the Show All button.
Sort	The list of claims is arranged by selecting an option from the Sort By dropdown. Options include Date of Service, Claim Sent Date and Patient Name.
DOS Date	Date of Service.
Sent Date	Date the claim was sent.
Patient	Name of the patient associated with the claim.
Patient DOB	The birthdate of the patient associated with the claim.
Subscriber	The name of the insurance subscriber. This is not necessarily the name of the patient.
Carrier	The name of the insurance plan carrier from whom payment is expected.
Type	Type of insurance –Dental or Medical.
Office	The office that originated the claim.
Bill	Billing Order
Provider	The provider that is associated with the claim. The Provider ID is established in the Provider Setup tool.
Charges	Total charges for the claim.
Est Ins (Estimated Insurance)	The estimated portion of the claim to be paid by the insurance carrier.
Ded Used (Deductible Used)	The amount charged toward the patient’s deductible.
Ins Paid (Insurance Paid)	The amount paid by the insurance to date for the claim.
D: Primary Dental DD M	Primary Dental Primary and Secondary Dental Medical

Selected Insurance Claim Details

The treatment specifics associated with the selected claim.


Selected Insurance Claim's Details	Description
Sel (Select)	Clicking this box selects the specific treatment for payment. The fee is automatically inserted as the amount paid when selected.
DOS Date	Date the treatment was performed.
Code	The ADA service or Practice Code for the treatment.
Th (Tooth)	The tooth associated with the treatment, if applicable.
Surf (Surface)	The surface associated with the treatment, if applicable.
Description	The description associated with the service code.
Provider	The provider that performed the treatment. The Provider ID is established in the Provider Setup tool.
Fee	Fee charged for the service.
Est Ins (Estimated Insurance)	The estimated portion of the treatment to be paid by the insurance carrier.
Ded Used (Deductible Used)	The amount charged toward the patient’s deductible.
Ins Paid (Insurance Paid)	The amount paid by the insurance to date for the treatment..
Ins. Adj (Insurance Adjustments)	The amount of adjustments made to the treatment.
Rem Amt (Remaining Amount)	The amount remaining to be paid for the treatment.
New Amt (New Amount)	The amount paid by the insurance carrier. When the treatment is selected, the fee is automatically added into this field. You can replace the figure with the amount actually paid by the carrier.
Disallow	The amount being disallowed by the carrier for the specific treatment. An adjustment can be applied for the single treatment as opposed to the full claim level (in the top section.). This can be done by typing the disllowed amount in the field and clicking the browse button to select the adjustment type.
Reason	Log the reason codes that indicates why a treatment was disallowed. It doesn’t appear directly in the ledger, but is captured for analysis via the QSIDental Web nightly download.

Click the Browse (… ) button to launch the Reason Code window and select for the specific reason the amount is being disallowed.
Select the Group Code from the dropdown.
Enter the specific reason code
Enter the Amount
Enter a “1” for quantity.

Note: The quantity field is part of the standard 835 communication and would be one in nearly all dental remittances.

Paid Claims

As claims are paid using the Batch Insurance Payment module, they are tracked at the bottom of the screen in the Paid Claims section.

Table 1.
Paid Claims	Description
Pay Date	The pay date that was entered in the PatientInsurance Payment section.
Patient	Name of the patient associated with the claim.
Subscriber	The name of the insurance subscriber. This is not necessarily the name of the patient.
Code	The ADA service or Practice Code for the treatment.
Description	The description associated with the service code.
Carrier	The name of the insurance plan carrier from whom payment is expected.
Provider	The provider that is associated with the claim. The Provider ID is established in the Provider Setup tool. If more than one provider is represented, *** will appear.
Check #	The check number entered in the Batch Insurance Check Detail section.
Amount	The total amount applied to the claim, calculated as the total paid for the treatments and displayed in the Patient Insurance Payment section.
Delete	Clicking the delete link removes the allocation to the specific claim. A confirmation window will appear before the deletion is performed.
Statement	Send a specific individual statement to this patient by printing and processing it locally.