FAQs‎ > ‎

Payment Section FAQs

Tip: Use your browser's search command (ctrl+f) to search these FAQs.

Patient Payment Questions

When posting a co-pay that will result in a credit, will the system set the credit to the right credit source?

Yes, if the payment being entered is causing an over payment on the account, the system will set the credit due to the respective credit source; whomever made the over payment (i.e., the patient or insurance). You can always change who the credit is due to within the Manage Credits  tab. The system will create a credit due to within the Manage Credits tab or within the Payment window while the payment is being posted. 

Insurance Payment Questions 

While posting denials, is there any option to select denial codes?

Yes. Reason codes can be entered while posting an insurance payment/denial. Visit the New Insurance Payment Help Page for instructions on how to post an insurance payment. 

Under the Insurance Payment tab when you right click there is an option to Open or Track? What does this option do?

The Open button will allow you to open the Claim,Patient, Payer or Provider listed on the claim. The Track button will allow you to track the Claim, Patient, Payer, Provider or EOB Check under Claim Tracking. 

When posting an insurance check, how do we move all patients into the posting field? Do we have to enter one by one or can we select them all?

When posting a New Insurance Payment, you have the option to search for claims one by one or you can search and select multiple claims that are at the payer you selected to post the payment under. 

How can I post capitation payments?

Capitation is a four part process. Follow each part below in order successfully setup and post capitation payments. 

Part 1 - Create a Patient
  1. Go to the Patient section and select the New Patient button.
  2. Patient's last name = Capitation, Patient's first name = Insurance Name (e.g., Medicaid).
  3. Enter all other required credentials. We recommend using either the practice or payer address in the address fields. 
  4. Click Save
Note: This will need to be done for each payer which participate in capitation. 

Part 2 - Create a Debit Code
  1. Go to the Codes section, Adjustments tab, and select the New Adjustment button,
  2. Enter a Code (e.g., Cap Pymt) and Description (e.g., Capitation Payment),
  3. Using the Type drop down, choose Debit.
  4. Click Save.
Note: This only needs to be completed one (1) time. 

Part 3 - Add Charge to the Patient
  1. Go to the Payments section, Manage Account tab, and Find the capitation patient.
  2. Select to Debit Account using the capitation code created.
Part 4 - Post the Capitation Payment
  1. Within the Payment section, go to the Payment tab and New Payment sub-tab.
  2. Enter the payment details using the capitation patient from Part 3. 
  3. Choose to Apply Manually
  4. Click OK on the pop up advising "No charges were found for the patient in the date range specified."
  5. Choose the option to Show Debit and then select Retrieve Charges.
  6. Proceed with posting the payment amount towards to capitation debit.
  7. Click Save.

How can I post an insurance payment without entering a check number?

In the event you want to post an insurance payment without a check number, there is a default that has to be enabled to make the Check# field optional.  
  1. Proceed to the Practice section
  2. Find and select your practice
  3. Click on the Defaults tab
  4. Click on the Payments Defaults sub-tab
  5. Uncheck the box next to "Make the Check# field optional for insurance payments"
  6. Click Save
Note: You must log out and log back in for this option to take effect. 

Is there a way to post an insurance payment without entering a check number?

The user is able to enable the check # field optional by completing the following steps:

1. Go to the Practice Section
2. Find and Select the practice
3. Select the Default tab
4. Select Payment Default sub-tab
5. Select the check box Make the check # field optional for insurance payments
7. Save

Note: The user will need to log out and log back into CollaborateMD to take effect

Can I apply a patient payment to a charge set to be paid?

Yes! Simply follow the steps below:

1. Go to the Payment Section
2. Click on the New Payment tab
3. Ensure Patient Payment is selected 
4. Populate the Payment Information
5. Click the Apply Manually button
6. Click Ok when the No Charge found message appears
7. Select the Include paid charges checkbox
8. Select the Retrieve Charges button
9. The patients' paid charges will populate
10. Enter the amount in the Apply Payment column
11. Save Payment

What is a PLB Adjustment Identifier?

PLB Adjustments can be found on EOBs or Electronic Remittance Advice. Provider-Level Adjustment (PLB) reason codes describe adjustments in the Medicare Contractor makes at the provider level, instead of a specific claim or service line. Some examples of provider-level adjustments include:
  • An increase in payment for interest due as a result of late payment of a claim by Medicare.
  • A deduction from payment as a result of a prior overpayment, and
  • An increase in payment for any provider incentive plan.
Most Commonly Used 835 Adjustment Codes.
  • Forward Balance (FB)
    • Used to reflect a balance being moved forward to a future remit or a balance that is brought forward from a prior Medicare Remittance Advice (RA).
  • Overpayment Recovery (WO)
    • Used when a previous overpayment is recouped from the practice or service.
    • Used when a reversal and corrected claim are not reported in the same transaction. WO prevents the prior claim payment from being deducted from the transaction.
    • Used to offset the PLB 72.
    • Used when a reversal and corrected claim are reported and the overpayment is not immediately recouped. WO prevents the prior claim payment from being deducted from the transaction.
  • Authorized Return (72).
    • Used to report the dollar amount returned by the provider of service for a previous overpayment.
    • Used to report a voided check.
  • Internal Revenue Service Withholding (IR).
    • Used for IRS tax withholding.
  • Non-Reimbursable (J1).
    • Used when the service provider is also the employer group and they request that monies be applied towards the Group Medical Plan coverage premium instead of the claim.
  • Interest Owed (L6).
    • Used to report interest paid on a claim.
  • Adjustment (CS).
    • Used to report the reissued payment amount for a lost check, or to reduce a PLB FB balance if CGS writes off an amount a provider owes. 

View Insurance Payment Questions

Do you recommend committing checks?

In the event you want to prevent users from making changes to a check once it has been applied, yes we recommend committing checks. Once a check is committed no further changes to the check will be permitted. Checks that have an unapplied amount cannot be committed until the entire check has been applied. 

How do you find a check that was applied and has a remaining amount?

The View Insurance Payment tab can be used to search for your applied checks.

How can you add more than one info line with multiple denial codes within the Insurance Payment tab so it goes onto each line?

In the Insurance tab, there's an option to Copy memos or info lines to all charges on the bottom left corner. You will have 3 options to choose from. 

Can I default my own Info lines when posting an Insurance Payment?

At this time, no; you're not able to set your own default/custom info lines. While you are able to enter custom text when entering payments, there is not a way to default it in the system. 

What are Parity Payments?

As part of the Patient Protection and Affordable Care Act (ACA), the federal government will fully finance the difference between the state Medicaid payment rate and the current year Medicare rate for two years (January 1st, 2013 through Wednesday, December 31st, 2014) for eligible primary care physicians. Payments have been delayed due to a lengthy attestation process used to determine physician eligibility. Click here for more information regarding Parity Payments

How do I post Parity Payments without generating an account credit?

1.  Adjust the original adjustment from the first insurance payment by subtracting the parity payment amount from the adjustment amount.
Example: If you have a $200 charge, and the Insurance Payment is $50.00, there is an adjustment of $150.00. Let's say the Parity Payment is $100.00. Subtract the parity payment from the original adjustment ($150.00) for a total amount of $50.00. $50.00 is the new adjustment amount. Your charge should have 2 payments including the original $50.00 insurance payment and the new $150.00 parity payment, and one adjustment of $50.00
2.  Create a debit adjustment to represent your new payment
2.1.  Go to the Codes section
2.2.  Go to the Adjustment tab
2.3.  Create New Debit Adjustment
2.4.  Once you've created your adjustment code you can apply your adjustment followed by your payment. 

Why doesn't the Total Check Amount match the Applied Amount when applying an insurance check payment?

CollaborateMD doesn't store or save Provider Adjustments (PLB segment) or Check Adjustments (check level CAS segment). 

There are two ways to resolve the amounts not matching:
  1. Post the Check Manually when ever you receive a Provider Adjustment / Check Adjustment
  2. Review the ERA and View EOB to determine if a Provider Adjustment or Check Level Adjustment has been applied to the check. If these types of Adjustments have occurred, and you desire to zero out the check's remaining amount, you will need to complete the following steps:
    1. Go to View Insurance Payment tab
    2. Open the check
    3. Manually change the Total Check amount

Electronic Remittance Advice Questions

What's an Electronic Remittance Advice (ERA)?

An electronic remittance advice (ERA) is an electronic data interchange (EDI) version of a medical insurance payment explanation. It provides details about providers' claims payment, and if the claims are denied, it would then contain the required explanations.

I’m missing an Electronic Remittance Advice (ERA), what should I do?

If you believe you are missing an ERA file, please note it normally takes 24-48 business hours from the Payer payment cycle to the receipt and availability of your 835 (remittance file). Under the Affordable Care Act Operating Rule 370, Section 4.3, late or missing is defined as a maximum elapsed time of four business days following the receipt of either the Healthcare EFT Standards or v5010 X12 835.

If you still don’t have the remittance file after four business days, the file could be "missing" for one of the reasons below:

  • Confirm that CollaborateMD does not have the remittance file:

    • Go to the Payment section > Payments tab > Electronic Remittance Advice sub-tab.

    • If applicable, use the search filters on the left-hand side to search for your check. Otherwise, click Search to use the default search parameters.

      Important: When searching for a specific remittance check please be sure to uncheck the “Include applied checks” box to retrieve all checks.

  • A payer agreement may not be authorized for the Submitter and Provider associated with the remittance file and payer in question. Click here for instructions on how to verify the status of an agreement.

  • Verify on the coversheet of the authorized agreement if your payer can take up to 45 business days to process your first electronic remittance file. Providers billing payers such as UnitedHealthcare may experience this type of delay.

  • Once you’ve verified all of the above, please use the Self-Service Portal to create a support case for a Customer Success Specialist to assist you further. If you don’t have access to the Self-Service Portal, please send an email to support@collaboratemd.com, titled "Missing ERA".  

    Important: The following information is required in order to perform our research (fields marked with a * are required), not including this information will delay your resolution:

    • CPID*

    • Check Number*

    • Check Amount*

    • Check Date*

    • Payee NPI*

    • Payee Tax ID*

    • Payee Legacy Provider ID (PTAN, if applicable)

If you don’t have this information please contact the payer for assistance.

Once this information is received, a Client Services Representative will research your request within 24-48 hours.

  • If the file from the payer has not been received, our Clearinghouse will reach out to the payer on the provider’s behalf to assist in locating the missing ERA(s).

    Important: Please note the Clearinghouse cannot perform their research without the requested information above.

  • In the event there’s an enrollment issue that prevented the delivery of the ERAs, an agreement will have to be completed to receive remittance advice electronically. Click here for instructions on how to complete payer agreements.

Back to Top

How can I print an EOB for a specific patient if a secondary insurance is requesting it?

Locate the check under Electronic Remittance Advice tab, You can also search for the patient in the Containing Content field, once you locate the check, click the View EOB button.

Where can I print an EOB so that I can manually post it? 

You can simply click on the View EOB button via the Electronic Remittance Advice tab a the ERA tab to print the RR (this report is generated by the Payer) or RE reports (this report is generated by the Clearinghouse). Note: You can also mark an ERA as applied manually in the event it was posted manually by checking the "Applied" check box within the Electronic Remittance Advice tab.

What does the 'download check file' button do?

This option is only available to CollaborateMD. 

How can I print old EOBs?

You can simply click the View EOB button via the Electronic Remittance Advice tab. 

Can secondary claims be sent electronically vs paper claim now through ERA?

Claims can be submitted to the secondary insurance electronically by simply changing the status of the claim to "Send to Payer via Clearinghouse" within the Payment window.  For more information please reference How to bill secondary claims

If an ERA indicates that the claim was forwarded to the secondary payer, will CMD automatically forward the claim?

When the Payer has indicated on the Explanation of Benefits (EOB) that the claim has been forwarded as a cross-over claim, CollaborateMD will set the claim status to "Claim at Secondary Payer" rather than "Send to Secondary Payer," this will help avoid claim denials for duplicate submissions. For more information please reference How to bill secondary claims

When posting an Insurance Payment, there is an "Unpaid" column. What does that represent?

The Unpaid column is calculated by subtracting the Payments and Adjustments from the Allowed Amount. 

Manage Account Questions

Where can I find a list of the patient credits?

This can be found within Manage Account tab under Account Credits Or within the Manage Credits tab.

Can we print the patient's credits from the Manage Account tab?

Yes. Click on the Activity tab and click on the View Activity button. This will allow you to see a list of open patient credits.

Can we modify the patient payment amount after it has been saved? 

No. You will have to delete the payment within the Manage Accounts tab and then post the correct payment within the New Payments tab. 

When changing the payer on the memo line, for example selected BCBS but was suppose to be Aetna, will the dollar amounts now be included in Aetna's total payments for the month or will it still be in BCBS totals?

Updating the memo line will not change the payer on the check. This will only show on the Activity tab. If you need to change the over all payer, you will need to do so in View Insurance tab. 

Can you make the Status drop-down when manually applying a payment to say “Credit Applied” instead of showing “Paid”?...

That way you can see that the credit was used to pay the balance off.

I do apologize, but at this time this isn't something that our application supports. The CollaborateMD Idea Exchange allows you to submit your improvement ideas on our Products, Services, Support, etc. to help us improve or innovate new ways of delivering value back to you and the user community. After an idea is submitted, our users as a community will vote and collaborate on the idea. The ideas that receive the most votes each month will be reviewed by our Idea Committee. The ideas that are determined to be of most value will be selected based on affordability and scheduled for a future release within our software. Visit, collaboratemd.ideascale.com.

Does editing the Date under the Charges, Payments and Credits tab change the end of day balance?

Yes, modifying the Received Date will change the end of day balance if running any reports by the Received Date. 

Why am I not able to see a claim that is in the system under the Manage Accounts tab?

The Manage Account tab will only display claims that are marked as "Complete". Click here for steps on how to Manage Incomplete Claims. 

How can I show only claims with a balance?
  1. Go to the Payment section
  2. Click on the Manage Accounts tab
  3. Click Find and locate your patient
  4. On the left side, under search criteria, select 'Only show claims with a balance'

The starting balance is showing as zero when posting a secondary payment. How can I post the secondary payment without creating an account credit? 

  1. Review the charge(s) that the payment is being applied to in the View Activity section so that you can validate that there is a balance present. Note: If there is no balance present for that charge, evaluate the claim activity to see if an over-adjustment was applied on the charge. 
  2. If an over-adjustment was applied on the charge, follow the steps to Delete a Transaction

Manage Credits Questions

Is there a way to pull up all patients with credits that need to be applied?

Yes. This can be done within Manage Credits tab. Manage Account will allow to to apply the credit as well. For instructions on how to apply a credit, visit the Apply Credit Help Page. 

Back to Top 

How do I transfer who the credit is due to?

Within Manage Credits you will have the ability to change who the the credit is due to. 

Misc Questions

How can I post an interest payment?

There are three steps to posting an interest payment, including the setup involved. If you have already completed Step 1, please move forward with Steps 2 and 3
  1. Create a Debit Adjustment code. An example of this type if code is "INTCHRG" for interest charge.
  2. Using Manage Account, post the debit towards the patient or towards the date of service.
  3. Finally, post the payment. HINT: Make sure to click the Show Debit button to post the payment against the debit added in Step 2.

Can we charge a patient for no shows?

Absolutely! To apply a no-show fee towards a patient's account you must create a Debit Adjustment. For instructions on how to create Debit Adjustments, please reference the following resources: 
  1. How to apply a Debit Adjustment towards the patients account
  2. How to apply a Debit Adjustment towards a specific claim 
  3. How to apply a Debit Adjustment while posting an insurance payment or patient payment

How do I post a recoupment? 

A recoupment can be posted within the New Insurance Payment tab or within the Manage Account tab. 

How do I post a refund/take back? 

A refund can be posted within the New Insurance Payment tab or within the Manage Account tab. 

Will alerts still display within the Payment screens?

Yes, no changes were made to Alerts.

Will you have the running list of payments that a patient has made even when you auto apply the payment?

A running list of patient payments can be found within the Activity tab under Patient Payments.

What is the procedure when processing a check that has been returned Non-sufficient funds (NSF)?

This procedure is really up to you! If you'd like to apply a NSF fee towards a patient account and reverse the payment that was originally applied, follow the steps below:
  1. A Debit Adjustment code for the NSF will need to be added. Click here to find out how to add the code.
  2. Find out how to add the debit adjustment NSF fee here
  3. Click here to learn how to Reverse the patient payment for a returned check. 

Why am I still receiving EOBs if ERAs are coming through CollaborateMD?

Even though you receive ERAs through CollaborateMD, the Payer may still send out paper EOBs. To stop receiving paper EOBs, please contact the payer directly.

General Questions

Is there an option to post a money order?

I do apologize, but "Money Order" isn't a Payment Type this time. Feel free to post this idea on our Idea Exchange website, collaboratemd.ideascale.com

If you have multiple line items per date of service and would like to adjust off each line item balance as a write off, do you have to adjust each line or can you adjust the entire balance??

While posting the payment within the Payment section, it can only be done per line item. You can do it in a batch within Patient AR Control

Can you print a patient statement from the payment section?

We currently do not have the option to print patient statements within the Payment section. This option is still available within the Patient or Control section. 

If there's no secondary attached to a patient, how do we add it? 

First, you will have to make sure that the payer is added withing CollaborateMD. You can find the instructions on how to add a Payer on the Payer Help Page. Once the payer is added, please be sure to add the payer to the Patients account and their Claim.

Once a claim is paid, does the remaining default to the secondary insurance or patient?

Yes, the system will set the balance accordingly.

How will the system auto apply checks with reversals or will they have to manually apply?

No changes have been made to the way reversals were applied in previous versions.

While posting a check can I write the balance off in a batch?

I do apologize, but at this time this isn't something that our application supports. Feel free to post this idea on our Idea Exchange website, collaboratemd.ideascale.comNote: To write off payments in a batch please use the Patient A/R Control tab within the Control section. 

When reviewing my patient activity, I noticed an item called "Negative Balance Transfer Credit". What does this mean and why am I unable to delete it?

A negative balance transfer credit occurs when an overage is posted to a charge.

Example 1: The charge amount is $20. A patient payment of $30 is applied to this charge. The $10 difference will transfer into a credit.  

Example 2: A payment has already been applied to a charge. A user then modifies the charge amount within the Claim section and saves the claim.

Now that this credit exists on the account it cannot be deleted/removed. The credit must be Refunded or Applied to another charge.

Why is there a negative dollar amount posted on the claim by the user “xgear”?

Negative payment amounts can be located within the Claim section > Activity tab.

Note:  Negative Balance Transfers are only created when a user manually edits the charge amount in the claim section AFTER payments/adjustments have already been applied to this charge. Charge amounts SHOULD NOT be altered if they have been sent to the payer and insurance payments have been applied to the claim.  

Solution:  To fix this, delete the Payment/Adjustment posted to this charge. Once deleted, the Negative Charge Balance Transfer can also be deleted. Click here for the steps on how to delete transactions.

Once the transactions are deleted, you can proceed with posting the correct payment and adjustment to this charge(s).

Back to Top

Can I change which provider a patient account credit is associated with?

No, once the account credit is saved, you must delete the transaction and re-enter the account credit. You may delete the transaction within Manage Account. Once deleted, re-enter the credit for the account. 

Important: Within the Credit Account pop up, please select the provider the payment should be posted under. This is imperative for reporting purposes.