Improve productivity by automatically posting insurance payments and streamlining the payment posting process. Billers or providers, depending on who is managing the billing process, can automatically post insurance payments with Explanation of Benefits (EOBs).
An Explanation of Benefits, commonly referred to as EOBs, is a statement from the insurance company providing details on payment for treatments or services you provided. It explains what portions of services were paid by the insurance payor. If you have not enrolled for ERA, you will receive EOBs and you need to post the EOBs through your zHealth account. Here is how to post an EOB.
1. At the top right corner of the zHealthEHR application window, you will see Your Name (Provider Name). Hover the cursor over your name and a drop-down menu will open.
2. Click on the sixth option - Billing Center . The Billing window will open.
3. At the Billing Center page, there is an option - EOB . Click on the EOB button .
4. You can search EOBs based on Insurance Name and Patient Name.
4 (i) Searching EOBs based on Insurance Name
a. Click on the radio button in front of Insurance if you want to search EOBs for a specific insurance company.
(i) b. Fill in the following details to search EOBs for a specific insurance company:
A list of EOBs* will come up based on the insurance company you selected.
*Note: Our system shows 100 EOBs per page by default. So if you have a number of EOBs, you will be able to view 100 EOBs per page. Click the "Next" button to view next 100 EOBs.
4 (ii) Searching EOBs based on Patient Name
a. Click on the radio button in front of the Patient if you want to search EOBs for a specific patient.
b. Enter the patient name in the box provided and click the "Search" icon. All EOBs related to this patient will come up.
c. A list of EOBs will come up related to that specific patient.
5. When you have a list of EOBs populated on the screen based on the Insurance Company or Patient Name you searched for, you need to click checkboxes under the 'Select' column to select EOBs you want to post.
1. First, click to select the EOBs you want to post. Then, click "Post EOB Payments" at the bottom of the page.
2. Once you click 'Post EOB Payments', the window refreshes and you will be able to see EOB details. Fill in the following details before applying payments.
a. To upload any EOB document, click "Choose file", browse the document file from your system, and then click "Upload" to upload the chosen document.
b. Manually enter the EOB amount. (Check your email or paper EOB received to enter the EOB amount).
c. Select from the dropdown whether you received the EOB through check, EFT, or credit.
d. Enter the check number if you received insurance payment through check.
e. This is the date when the check was written.
f. This is the date when you are posting the payment or want to show in the software/reports.
g. This is the date when the money is deposited in your bank.
h. Enter the new insurance payment
i. Enter the insurance adjustment amount.
j. Enter patient balance amount.
k. When you type the insurance adjustment amount, you will see the Remaining Balance amount automatically.
l. Click 'Detailed Payments' if you want to enter detailed insurance amounts paid for each CPT code and patient responsibility.
m. Click on the dropdown button of 'Action' to Close, Rebill or put the EOB 'On Hold'.
n. At any time, you can add your claim to an EOB by clicking on the 'Add Claim' button.
o. Remove any claim from the EOB by clicking the 'Remove Claim' button.
p. Click 'Apply Payments' once you have filled in all details.
q. Click 'Save' if you want to save the EOB details in the system.
3. When you click "Detailed Payment" in the EOB screen, you will see the following info:
a. Active Secondary Insurance name
b. Patient name
c. Claim number
d. Insurance payer name
e. Action, whether you want to "Close", "Rebill", "Crossover", "Bill Additional Ins (Paper)", or "Bill Additional Ins (EDI)".
f. Processed as Primary, Secondary or Tertiary Insurance or select other options from the drop-down.
g. Insurance paid amount
h. Insurance adjustment group
i. Insurance adjustment amount
j. Reason for adjusted amount
k. Patient responsibility
l. Reason for the Patient Responsibility
1. To view an uploaded EOB scan copy, you need to first go to the "Billing Center". Hover the cursor over your name on the top right corner of your zHealth dashboard. Click "Billing Center". Then click "EOB" button on the top of the page.
a. Once you're on the EOB page, click "EOB" radio button. All EOBs will be displayed on the bottom with EOB ID, check number, post date, amount, and status.
b. To search for all EOBs posted within a date range, you can enter the Date Range. Click "Search".
c. To search for a specific EOB, you have two options. First option, enter the Check Number*. Click "Search".
d. Second option, enter the EOB ID**. Click "Search".
e. Once you have searched for a specific EOB(s), you will be able to see an option to View an Uploaded EOB*** under the "Actions" column.
*Note: To find the Check #, you can go to a Patient Chart > Patient Billing > Open the Invoice for which you want to view the Check # > Go to Invoice Payments section. You will be able to view the Check #.
**Note: To find the EOB ID, you can go to a Patient Chart > Patient Billing > search for the Invoice for which you want to view the EOB ID > Click "Four Horizontal Lines/Claim Audit" icon. You will be able to view the EOB ID. (Please check the second image on the right side.)
***Note: "View Uploaded EOB" will only be available if the EOB scan copy is already uploaded.
2. When you click "View Uploaded EOB", a pop-up window will open. You can view the uploaded PDF or scan copy of the EOB.
3. To upload an EOB copy after posting an EOB, you can click the "Post EOB Payments" as shown here.
4. You will be taken to the EOB Posting window. To upload an EOB document:
a. Click "Choose File". Choose a file from your system.
b. Then click "Upload" to upload that EOB file to the posted EOB.
c. Click "Save" to save the changes.
Now, you can see the "View Uploaded EOB" button on the EOB search screen.