Entering an Insurance Payment for more than the Estimated Portion

The following is an explanation of how to enter an insurance payment when it is for more than the estimated insurance portion that is shown on the Transaction screen.

When you receive an insurance payment for more than the estimated portion, the entire insurance payment can be distributed to the estimated insurance amount on the distribution window. You do not have to modify the estimated insurance amount on the Transaction screen first.

The Payment Distribution window will show the original estimated insurance amount. It will be highlighted in blue. Just type the amount of the actual insurance payment when the Payment Distribution window opens.

A message will appear stating that “The amount entered exceeds the estimated insurance for the selected transaction.” This simply means that you are entering an insurance amount greater than the amount that was estimated on the Transaction screen.

MOGO will then say, “If this amount is correct, click Continue for the option to update future insurance estimates. Otherwise, select Back to re-enter the amount”.

When you click on the Continue button, MOGO will automatically shift any patient estimates to the insurance estimate so that you can link the full insurance payment amount. You will also be given the opportunity to update insurance estimates.

You can click on the Back button if you want to re-enter the insurance payment amount.

If necessary, MOGO will ask if you would like to re-link remaining patient payment to other treatment or even to other family members. If there is no other patient portion due, the patient payment amount will remain on the Transaction screen in green as an overpayment. You can always link it to future treatment or to other family members.

Tip: Remember to fill in your Office Setup first. You will have an option in Office Setup under the Insurance Tab to “Link insurance payments to patient portion when insurance balance is 0”.

When you right click on an insurance claim code and select Enter Insurance Payment, the distribution window will include treatment that has zero estimated insurance. This will allow you to quickly link an insurance payment and update the insurance plan even when there is no estimated insurance portion!

If you enter an insurance payment on the Transaction screen by typing your insurance payment code, you will see an option to “Include Patient Balances” at the bottom of the insurance payment distribution screen. If you mark this option, it will include treatment with zero insurance estimates.

When the insurance pays more than the estimated insurance amount and the patient has already paid their portion, you do not have to break the distribution link for the patient payment in order to link the full insurance payment amount. And you do not have to wait to distribute a patient payment until after the insurance payment is received.

Enter the insurance payment as usual and link to the treatment. When the distribution window opens, it will display the insurance amount that was estimated. Just type in the amount of the actual insurance payment. The following message will appear giving you the option to link the full amount paid by the insurance:

“The amount entered [dollar amount] exceeds the estimated insurance [estimated insurance amount] for the selected transaction. If this amount is correct, click Continue for the option to update future insurance estimates. Otherwise, select Back to re-enter the amount.”

When you click on the Continue button, you can link the full insurance amount to the treatment as well as update insurance.

The patient payment that was linked to this transaction is now broken. Another message will appear asking if you would like to redistribute the patient payment. You can distribute the payment to this patient or even to other family members.

Note: If you redistribute a patient payment to a different provider, a message window will suggest that you link the payment on the current date and it will remind you that you need to regenerate your reports by provider.

If there is no patient portion due, MOGO will let you know that the patient payment amount will remain on the Transaction screen as an overpayment. Overpayments appear in green and can be distributed to future treatment for the patient or any family member or even reimbursed to the patient.