Posting External Claim Transactions

An external claim is a claim you billed through another billing system, and therefore do not have a record of in Claims Management.

You can post only external claim transactions when processing carrier payments.

If you receive a payment from an insurance carrier for a claim that you created from a billing system that is not Claims Management, post an external claim transaction:

  1. On the top menu bar in Encompass, click Claim Management and select Claim Management.
  2. On the top menu bar in Claim Management, click Process Payments and select Carrier Payments.
  3. Search for the payment and click the Reference Number link in the results list.
  4. Under Related Claims, click Post External.

    The Post External Claim Transactions window opens.

  5. Enter the Claim Number.
  6. Enter or select the Service Date.
  7. In the Transaction Amount text box, enter the amount of the check that you’re posting toward the claim.
  8. Enter the Patient First Name.
  9. Enter the Patient Last Name.
  10. Enter the Insured ID.
  11. Enter or select the patient’s date of birth in the DOB text box.
  12. Enter the Provider First Name.
  13. Enter the Provider Last Name.
  14. Click Post Transaction.

    The external claim appears in the Payment Detail panel.