There are many situations requiring a biller to create a payment event by hand. This guide explains how to do it.
Before continuing, be sure you understand how AngelTrack calculates the balance due.
If you are regularly entering paper EOBs received from insurers, contact your clearinghouse and sign up for electronic ("EDI") documents. AngelTrack can process electronic insurance documents for you, saving you the enormous hassle of manual data entry.
To learn how electronic claims and electronic EOBs work, read the EDI Primer. To learn how AngelTrack can automatically transfer your electronic claim batches up to your clearinghouse, and pull down all electronic replies from the clearinghouse and carriers, read the Clearinghose Uploader/Downloader Guide. To learn how to import an electronic EOB into AngelTrack, read the Importing X12.835 EOBs Guide.
AngelTrack's claim control numbers are distinctive, and so are easy to find on a paper EOB:
This is assuming you used AngelTrack to code and file your claims; if you used a different billing application, then consult that application's help to learn what its claim control numbers look like.
To learn more about how to read a paper EOB, including how to find the AngelTrack dispatch ID, check out the Reading an EOB Guide.
A well-run billing office enters at least 95% of its claims electronically, by importing the EOB datafiles directly into AngelTrack. Less than 5% of your payment events should be from paper EOBs, typed in manually. If you are doing more than 5% of your EOBs manually, call your clearinghouse and ask to be switched to electronic statements.
Manually-entered payment events have all of these drawbacks:
Payment events are always associated with dispatch records. Therefore to record a payment event you must first locate the dispatch record that incurred the payment.
The quickest way to retrieve a dispatch record, when you already know its dispatch ID, is to use the Genie. Simply press ALT+G from any AngelTrack back-office webpage (i.e. from any AngelTrack page that has a white background). The Genie will popover the current page, without disturbing your work there. Type in the dispatch ID, but don't hit ENTER; instead, press the 'A' key. The Genie will open the Payment Event Add page for you.
Although the Firefox web browser is not officially supported by AngelTrack, if you use it anyway, you may discover that the Genie's ALT+G shortcut doesn't work. Instead you must click the magic lamp icon from the menu at the top of the page.
If you already know the patient and have their patient record open, just switch to the "History" tab. It will show all of their transports, going as far back in time as you wish. Or use the "Receivables" tab, which shows just those transports with an outstanding balance.
The Record a Payment Page has a combination of filters for rapidly locating any dispatch record. You can search by date range, patient name, dispatch ID, origin facility, patient date of birth, and service level. In the result grid you can click the 
icon to add the new payment event.
For example, suppose you are entering the data from a paper EOB. EOBs often list all services rendered to a patient over a period of time. In such cases, use the patient name and DOB fields to find all the patient's dispatches, and then use the 'Date of Service' filters to zoom in on just those dispatches covered by the EOB.
EOBs from Medicare and Medicaid often include the combined HCPCS code for the transport; for example, transport from a hospital (HCPCS code H) to a skilled nursing facility (code N) is listed as 'HN'. On the Record a Payment Event page, the list of dispatches includes the combined HCPCS code for each item, shown next to the service level. (If you don't see these codes listed for your dispatches, then you need to edit your Facility records and set their HCPCS codes.) The combined HCPCS code makes it easy to tell the difference between an outbound trip (e.g. NH) and the return trip (HN), which is otherwise difficult to tell just by looking at a typical EOB.
Click the button to record a payment event for the selected dispatch. A new window opens to collect the relevant information from you. This window is reused every time you click the button to record a payment event, so if you are processing several payment events (e.g. inputting a combined EOB statement for several patients), leave the new window open and over to the side, so that you can switch back and forth between it and the Record a Payment Event page.
You can enter any or all of the following pieces of data, or leave them blank:
AngelTrack uses "lazy price quoting", which means that some dispatches will be quoted up-front during call-taking but most dispatches will not have a final price until late in the billing process.
Calls billed to insurance are generally quoted at retail, and then the insurance carrier sends back a discounted price called the "allowed price". Both prices should be recorded; thereafter, the allowed price will determine the balance due, while the quoted price (at retail) will determine the "contractual adjustment" tax writeoff.
Various events in AngelTrack can automatically set a dispatch's price quote. Therefore the field may already be filled-in for you. You can set, alter, or clear the price quote at this time, as you see fit.
You can leave the price quote blank if you will later be invoicing the call, because the invoice generators will calculate the price quote automatically.
This field contains a current total of service charges and discounts recorded for the dispatch so far. Fees and discounts are credited against the balance due, same as payments received... unless the patient's insurance company has adjudicated a price, in which case discounts and service charges no longer apply.
This field is for storing an adjudicated price determined by the primary insurer... information that is always communicated in an approval EOB.
If there is no adjudicated price -- i.e. if billing the dispatch at full retail price -- then just leave this field blank.
This field contains a current total of all payments recorded for the dispatch so far.
Remember that payment events can be freely deleted and undeleted by anyone with biller privileges. Deleted payment events are not included in this total.
This field is calculated for you, using the above four pieces of information. After an insurance payment is received, the "Balance due" should match the copay (often shown on the EOB as "Coinsurance" or "COINS" or "Patient pays").
Specify the type of event you are recording:
If recording an approval, payment, or denial, here you specify monies received from, or refunded to (clawed back by), the payor. Specify a positive number for monies received by EMS, or a negative number for monies refunded to (clawed back by) the payor.
If the EOB is from Medicare or Medicaid, then it probably also contains CO*253 reductions. Place your cursor into this field to display the calculator to help you input the CO*253 amounts. Read the EOB Price Allowed and Amount Sequestered guide to learn more.
Leave the field blank if you are typing in the whole table of adjustments from a paper EOB; as you type, the total amount sequestered will be calculated for you.
If recording an approval, here you specify any other discount applied to the balance due, such as courtesy discounts awarded to the patient. They are credited against the balance due, just like a payment received.
This field contains the patient responsibility amount adjudicated by the carrier. The primary carrier normally leaves a positive PR amount, while the secondary carrier normally leaves a zero PR amount. If you leave the field blank, and no PR amount is already on file, then the patient will be invoiced for the entire balance.
To learn more, read the Patient Responsibility guide and how AngelTrack calculates the balance due.
Leave the field blank if you are typing in the whole table of adjustments from a paper EOB; as you type, the total PR amount will be calculated for you.
This field contains the date the event occurred. Typically this is the "date processed" from the EOB, not the date you recorded the EOB. That way you can later match up your records with insurance company records. AngelTrack will automatically store (in a separate field) the date you recorded the event.
The field is automatically populated with the date you used last time, because EOBs often contain batches of payments all bearing the same processing date.
This field allows you to specify the other party to the event, be it insurance, or the facility, or the patient. If the other party is insurance, specify which type of insurance.
This field is for including explanatory notes for the benefit of the customer or other billers. If there is anything unusual about the EOB, take the time to explain it here.
Click the button to attach an electronic EOB, such as a .PDF or a scanned fax. The EOB will be stored in AngelTrack for review later.
If the EOB is a .PDF file containing multiple page images, AngelTrack will dissect it and then prompt you to select the image that is most appropriate.
If not allowing AngelTrack to automatically decide the next steps, then pause and give thought to the next step in the workflow. This is where you make a tactical decision: what happens now? Do we take action, or do we continue to wait? And who are we waiting on?
Your decision is expressed in the Postprocess Status and in the Payor. Change the Postprocess Status to Billing office to send it back to your billers for more processing, or to Awaiting payment if there is nothing more to do but wait, or to Finished when it is paid off or written off. Likewise, change the Payor if it is time to go after someone else for the balance: for example, once insurance is exhausted, change the Payor to the facility or the patient, whoever is responsible for the balance or copay.
This decision is a critical step in the workflow; more details below.
Once entered, click 'Save'. The window then changes to an acknowledgement screen, showing a table of all recorded payment events for the dispatch. Use the table to check your work before proceeding.
If the primary carrier sends only paper EOBs, but the secondary carrier requires an electronic claim, then you must input into AngelTrack the entire chart of the primary carrier's adjustments:
In the Add Payment Event page, below where you select the payor, click the link "Input the adjustments from a paper EOB, for use in filing an electronic secondary claim" to open the chart of service lines, which looks like this:
Enter all of the adjustments into the little tables at right, being careful to match up the service lines, and double-checking your numbers. The data will then be saved with the payment event, and thereafter used to emit any secondary claims where the carrier needs to know what adjustments the primary made.
If you make a mistake and need to edit your work, simply click the payment event to open the Payment Event Edit page, switch to the "835 Decoded" tab, and make the necessary adjustments.
This field is for listing the RAR codes ("RARCs" or "remittance advice remark codes") returned by insurers. These are sometimes listed on EOBs under the heading "MOA". They all begin with 'M', 'MA', and 'N'. They explain the reasons for adjustment or denial. Just type them in separated by spaces; afterward, AngelTrack will automatically look up and display their meanings. RAR codes caused by missing documentation or coding errors will be highlighted in yellow, and will automatically raise the yellow exception flag 
.
The remark code MA125 is special, as it voids any PR amounts as statutorily prohibited from being collected from the patient. When MA125 is present, AngelTrack regards the PR amount as zero.
Many payment events will trigger a change to the dispatch's Postprocess Status, or to its Payor, or both. AngelTrack offers to make this decision for you, either semi-automatically (where you review it afterward), or fully automatically, or showing you the recommendation and letting you click the buttons to implement it if you agree.
If you choose to manually decide the next step, here is a primer on the most common situations requiring a change:
When the received payment covers the insurer obligation and all that remains is the copay, then move the dispatch to 'Billing Office' and change the payor to 'Patient'. This will cause the dispatch's remaining balance due to show up on the next batch of patient invoices.
The Invoice Generator for Patients will then push the dispatch forward to 'Awaiting Payment' once the proper invoice is generated and committed. (further reading)
When the received payment covers the entire balance due (e.g. patient has no copay), then move the dispatch to 'Finished'.
When the primary insurance carrier approves the claim but fails to automatically forward to the secondary, then you must file against the secondary yourself. Send the call back to 'Billing Office', and keep the Payor set to 'Insurance', so that the call will reappear in the Insurance Filing Queue to be batched up for the secondary carrier.
In order to do this, you must type in the table of CARC adjustments from the primary carrier's EOB, as illustrated above. This data is required by the secondary so that they can account for the primary's discounts and adjustments.
In this situation, AngelTrack will automatically switch the associated dispatch's coding target from the primary carrier to the secondary. The dispatch will reappear in the Insurance Filing Queue to be batched up for the secondary.
When denied by insurance and in need of resubmission to the insurance company or to a different insurance company, then move the dispatch to 'Billing Office'. It will then appear in the Insurance Appeal Queue.
When denied by insurance and therefore the responsibility of the facility, then move the dispatch to 'Billing Office' and change the payor to 'Facility'. This will cause the dispatch's remaining balance due to show up on the facility's next invoice.
When denied by insurance and therefore the responsibility of the patient, then move the dispatch to 'Billing Office' and change the payor to 'Patient'. This will cause the dispatch's remaining balance due to show up on the patient's next invoice.
When processing a full cash payment from a patient, simply push the dispatch forward to 'Finished'.
Remember that when cash-pay dispatches graduate QA (or skip it), they advance immediately to 'Awaiting Payment'. They do not stop at the billing office first; rather, they assume the driver has already collected the money and will turn it in at the station for processing. (further reading)
When processing a partial cash payment from a patient, and the payment does not cover the entire balance due, then move the dispatch to 'Billing Office' if you want to re-invoice the patient for the remainder:
If, on the other hand, you plan to simply wait for the patient to send in the balance, then leave the dispatch at 'Awaiting Payment'.
When you give up attempting to get paid for the dispatch, you can write it off by simply moving it to 'Finished'. Its uncollected balance will thereafter show up in AngelTrack's tax reports.
You can do this at any time, regardless of what billing activity has already been done. And you can always record additional payments, or move it back to 'Billing Office', whenever you wish. The only requirement for advancing a dispatch to 'Finished' is that it must have a price quote. The price quote is used to calculate the tax writeoff. To learn more about tax calculations, read the Taxes and Collections guide.