How to Enter a Claim Denial With a Zero-Dollar Insurance Payment

Note: This feature is for US customers only.

When a claim is denied with an Explanation of Benefits (EOB) payment of $0 toward the claim, use the New Payment function to enter the $0 amount and close the claim. This creates an entry on the Ledger indicating that the claim has been closed with a $0 payment. The process then prompts you to take next steps to bill the patient's secondary insurance or post a write-off.

To enter a $0 payment for a claim:

1. From the Patient Ledger, select New Payment. The Post New Payment window is displayed.
2. In the Amount Paid field, enter $0.00.
3. For the Payment Type, enter Insurance (Check, Credit Card, or EFT). The Claim Number field is displayed.
4. Use the Claim Number field to search for and select the associated claim.
5. Use the Comment field to enter the reason the payment amount is $0 (i.e., annual benefit limit reached, allowed frequency exceeded, etc.). 
6. Click Post Payment. You are prompted with a message to Perform Next Steps.
   
7. From this prompt, you can:
   - Select Bill Next Insurance if the patient has an additional policy in effect to initiate the steps to bill that policy for unpaid procedures.
   - Select Post Write-Off. The Adjust Balance window is displayed, where you can write off all or part of the unpaid claim amount. 
   - Select Handle Later. The line item is added to the Ledger indicating that the claim has been closed and the payment amount is $0. The patient's balance is not affected.

Note: You can also enter a $0 payment amount when adding the details of a Bulk Insurance Payment, to indicate that the selected claim is closed and proceed with next steps. For more information, see How to Enter Bulk Insurance Payments.