Configure Payments and Billing in Practice Settings

Let’s explore how to configure different areas of Payments & Billing through Practice Settings.

Topics Covered

• General
• Insurance Payments
• Statements
• Claim Form Defaults
• Claims/Pre-Auth Flags
• Attachment Recommendations
• Services
• Contract Agreements

General

How to Add a Payment Type

• Navigate to the System Menu > select Practice Settings > Payments & Billing > General.

• Enter Payment Type Name > Select Category such as cash, check, etc.
• Select the options under Additional Fields Required if needed:
  • Flexi Pay: The label to attach to the payment, often used as an indicator for an FSA or HSA payment.
  • Reference No: Select the checkboxes to indicate whether a reference number is required for the patient, insurance, or collection.
• Select Payment Type In. Select the sections where you want the Payment Type to be listed, such as patient payments, insurance payments, etc.
• Click Save.

Note: To edit an existing payment type, select the payment type and click Edit. Make the required change(s) and click Save.

Configuring Billing, Ortho, and Other Settings

•  Select Billing, Ortho, or Others tab as needed > Click Edit.

• Make the required change(s) > click Save.

Insurance Payments

• Navigate to the System Menu > select Practice Settings > Payments & Billing >Insurance Payments.

Under Insurance Payments, you will see four tabs. The following section provides an overview of their corresponding configurations.

Insurance Payment Flags

Insurance Payment Flags are used to identify or classify insurance payments, especially for situations that require special attention, such as payments with issues, multiple claims, or chargebacks. These flags help users quickly recognize the nature of the payment when viewing the Insurance Payments module. Practices can create and customize their own flags to suit their specific needs and workflows.

To create a new flag, perform the steps below.

• Click + Add Flag > enter Flag Name, Short Name, and Description > select flag Color > click Save.

ERA Posting

The ERA Payment Posting Preferences in CareStack allow you to configure how your Electronic Remittance Advice (ERA) insurance payments are auto-posted to their corresponding claims.

•  Select the ERA Posting tab.
• Select the Account or Location tabs as needed.

• To configure at the Account level,
• Choose the Account tab.
• Click Edit on the ERA Payment Posting Preferences section.

• Configure the following settings:
  • Default Payment Type for Check: Choose a default payment type for check.
  • Default Payment Type for Direct Transfer: Choose a default payment type for direct transfer.
• To enable auto-posting, set Auto-post ERAs while Parsing as Yes.
• To auto post ERAs if the payment is as expected, set Only post if paid as expected to Yes. 
  • Set this as No to set a trigger criteria for an adjustment amount difference.
• Do not Auto-post ERAs with Payment Type: Choose the payment type you do not want auto-posting to be initiated for.
• To set auto posting trigger criteria for an adjustment amount difference at the Claim and/or Line level: 
  • Select the formula: Less than or equal to or Greater than or equal to.
  • Enter the amount.
• To exclude certain ERAs from auto posting, enable the Exclusion Criteria toggle.
  • Exclude for selected Codes: ERAs containing claims with any of the selected codes will be skipped from auto-posting.
  • Exclude for selected Carriers: ERAs associated with the selected carriers will be excluded from auto-posting.
• Click Save.

• To override the Account level settings at the Location level,
• Choose the Location tab.
• Select the intended location.

• On the ERA Settings slide-out,
• Click Edit.

• Set Use Account Settings as No to override the account-level settings.
• Configure the following settings:
  • Default Payment Type for Check: Choose a default payment type for check.
  • Default Payment Type for Direct Transfer: Choose a default payment type for direct transfer.
• To enable auto-posting, set Auto-post ERAs while Parsing as Yes.
• To auto post ERAs if the payment is as expected, set Only post if paid as expected to Yes. 
  • Set this as No to set a trigger criteria for an adjustment amount difference.
• Do not Auto-post ERAs with Payment Type: Choose the payment type you do not want auto-posting to be initiated for.
• To set auto posting trigger criteria for an adjustment amount difference at the Claim and/or Line level: 
  • Select the formula: Less than or equal to or Greater than or equal to.
  • Enter the amount.
• To exclude certain ERAs from auto posting, enable the Exclusion Criteria toggle.
  • Exclude for selected Codes: ERAs containing claims with any of the selected codes will be skipped from auto-posting.
  • Exclude for selected Carriers: ERAs associated with the selected carriers will be excluded from auto-posting.
• Click Save.

Adjustments

• Select the Adjustments tab, you can view the Auto Adjustment Setting.
• Click Edit to configure the setting.

• Make the required change(s) to the Default Adjustment Codes.
• Click Save.

Other

• Select the Other tab to configure additional settings for Insurance Payment Posting Defaults.

Statements

CareStack offers practice flexibility when customizing Patient Statements. Let's explore the Template, Generation Criteria, and Other Settings one by one.

How to Set up Statement Configuration

• Navigate to the System Menu > select Practice Settings > Payments & Billing > Statements. 

• Select Template Settings. 
• To customize the template, click Edit.

• You can change the following settings to suit your practice's requirements.
  • Statement Header
  • Return Address
  • Remittance Address
  • Additional Settings

Note: Account Name and Address details used for Statement Header, Return Address, and Remittance Address are sourced from Practice Settings.

• Click Save.

Let's check out the next tab, which is Generation Criteria.

• Click Generation Criteria > Click Edit > Make the required change(s) > click Save.

To customize the Other Settings section at the top left.

• Click Other Settings > Click Edit at the bottom right > Set your preferences > click Save.

Note: Practices can choose Other Settings to enable Print or Mailing Service or to upload electronic statements to the Patient Portal. You may also set the criteria to send separate or combined statements when the patient's account holds a balance in more than one location.

Claim Form Defaults

This section allows you to configure the Claim Form Default settings for dental and medical claims, ensuring your preferred settings are applied each time you open a form.

• Navigate to the System Menu > select Practice Settings > Payments & Billing > Claim Form Defaults.

• Select Dental or Medical Claim Defaults.
• Click Edit. 

• Make the required change(s) > click Save.

Claims/Pre-Auth Flags

How to Create a New Claim/Pre-Auth Flag

• Navigate to the System Menu > select Practice Settings > Payments & Billing > Claims/Pre-Auth Flag.

  

• Select the Claims or Pre-Authorization as required.
• Click + Add Claim Flag.

• Enter the desired Flag Name.
• Add a Description that clearly explains the purpose and use of the flag.
• Select the desired Color to be associated with this flag.
• Click Save, once you are finished. You can always click Edit and make any change(s) to the settings.

• To activate or deactivate a flag, select the checkbox of the intended flag > click Activate or Deactivate as required.

Attachment Recommendations

How to Add an Attachment Recommendation

• Navigate to the System Menu > select Practice Settings > Payments & Billing > Attachment Recommendations.

• Click + Add Attachment Recommendation.

• Select Code Description > Attachment Type > Insurance Carrier.
• Click Save.

Services

How to Configure Payment Services, Portal Payments, or Billing Services

• Navigate to the System Menu > select Practice Settings > Payments & Billing > Services.

• To configure Payment Services, select the required payment service tabs and click Edit.
  • These change(s) apply at an Account Level.

• Make the required change(s).
• Click Save.

Under External Payments, you can configure Account Settings for external payments and Available Services.

• To configure Account Settings, click Edit.
• Make the required change(s).
• Click Save.

• To configure Available Services, click Configure for the relevant services.

The Billing Services section allows you to configure Payment Gateways, NEA, Portal, and Claims at a location level.

• Click the desired line item to open its configuration modal.

• You can view all configuration aspects of the services.
• To make change(s), select the required option on the left and click Edit.

Contract Agreements

How to Edit Contract Agreements

• Navigate to the System Menu > select Practice Settings > Payments & Billing > Contract Agreements.

• You can view four types of contract agreements.
  • Ortho Plan
  • General Payment Plan
  • Membership Plan
  • Payment Method on File
• Select the required Contract Agreement Type > Click Edit.

• Make the required change(s). 
  • You can use the standard formatting tools.
• Click Update.

Practices can use this comprehensive guide to easily learn how to configure different areas of Payments & Billing through Practice Settings.