Payments
Payment variances
Find insurance payments that came in below or above the expected allowed amount and work them to a close.
Every charge carries an expected allowed amount from the payer's allowed schedule in Setup. When you post an insurance payment, by hand or from a remittance, NeatPractice adds what the payer paid to what it left to the patient (deductible, coinsurance and copay). That total is what the payer allowed. When it differs from the expected allowed amount by more than your clinic's tolerance, the line lands on Payment variances under Payments in the Billing panel.
- Underpaid: the payer allowed less than expected, so money may be owed to you.
- Overpaid: the payer allowed more than expected, so the payer may ask for it back.
Only the payer the charge was billed to is compared, and only charges with an expected allowed amount. Denied lines go to the denial worklist instead.
The tolerance#
Choose ERA Settings on the remittances page and set Variance tolerance ($) and Variance tolerance (%). A line is flagged only when the difference is larger than both: with the starting values of $1.00 and 2%, a $1.50 difference on an $80.00 line stays quiet, and a $10.00 difference is flagged. Set both to 0 to flag every difference.
Work the list#
The list shows open and appealed variances, follow-ups due first and then the largest differences. Filter by status, kind, payer, when the variance was found or its size, turn on Follow-ups due, or pick patients in the patient panel. Each row shows the expected allowed, what the payer allowed (paid plus patient), the difference and the status.
From a row's menu:
- Work Variance: set the owner, a follow-up date, the date an appeal was sent, the status and a note.
- Appeal Letter: for an underpayment, download a letter asking the payer to review the allowed amount. Sign it and send it with your fee schedule.
- Adjust Balance: open the charge's balance to post a write-off or other adjustment.
- Open Claim: open the claim, for example to send a corrected claim.
Statuses#
| Status | Meaning |
|---|---|
| Open | Found and waiting for someone to work it. |
| Appealed | You asked the payer to review it. Enter the date the appeal was sent. |
| Resolved | Settled. Choose why (paid on appeal, the expected allowed was wrong, the payer took it back, refunded to the payer, not worth pursuing, or other) and add a note. |
| Written off | You decided not to collect the difference. Post the write-off with Adjust Balance, then choose a reason and add a note. |
Posted payments and adjustments never change here. When a later payment from the same payer posts on the line, for example after an appeal, NeatPractice closes the old variance as Replaced by a later payment and opens a new one only if the line is still off; the new one keeps the owner, follow-up date and appeal. Reversing the payment that found a variance closes it as Payment reversed. Every change is kept in the audit log.
Report#
The Payment variance by payer report under Reports shows, per payer, how many lines were underpaid and overpaid, the amounts, the net difference and how much is still open. See the report catalog.