Create an EOB
An EOB is a statement from your health insurance plan describing what costs it will cover for medical care or products you’ve received. The EOB is generated when your provider submits a claim for the services you received.
In accounting you can enter this information under Transactions > Accounts Receivable > Explanation of Benifits
First, select the insurance company
The insurance is where the payment is coming from. Select the company from the drop down list.
Next, select the customer
After selecting the insurance, the customer dropdown under Open Invoices will populate with all contacts that have open invoices for the selected Insurance.
Choose the invoice the payment is for
Selecting the customer will populate the grid with the available invoices that can be added to the EOB. Tick the checkbox next to the invoice the payment is for.
Add to transactions grid
Click the Add to EOB button after selecting the invoice to add.
Edit invoice payment
Click the edit icon to edit the details of the payment
Enter payment information
Here is where you will enter the payment information.
Provider Charge : The amount that was charge to the payer.
Allowance : Maximum allowed charge as determined by your plan. This is the Contractual Obligation from the payer, the amount between what you billed and the amount allowed by the payer when you are in-network with them.
Non Charge Amount : The amount that payer is not paying
Write-Off Account: The account the Non Charge Amount will be taken from if Accept As Paid In Full is checked
Member Liability : The amount the customer owes according to the payer.
Other Insurance Amount - The amount to be transferred to another insurance company.
Waterfall To - The insurance company to be charged with the amount entered in Other Insurance Amount.
In this example, the payer is paying 70.00
They are contractually obligated to pay 80.00 for this service, and the client has a co-pay of 10.00
In the Allowance field, enter the 80.00
The other fields will adjust based on that.
Ticking the "Accept as Paid In Full" checkbox will set the Non Charge Amount
Save Transaction
Once the payment details have been entered, click the Save transaction button
Post EOB
After adding all the payments to the EOB, fill in the summary information
Date: the date of the payment
Memo : (optional) short description of payment
Check Number : The check number from the ERA payment
Payment Amount: The amount the check was for
If all payments have been entered, the Unapplied Amount should be 0.00. If there is a value there, you should not post the EOB
Post EOB
Click the post button to post the payment. This will make the adjustments to the invoices in accounting.