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FAQS:
FAQ 14941 – How to Apply Unapplied Balance
FAQ 14313 – Transaction Audit Trail Report
FAQ 13387 – Reports and Definitions
Unapplied Balances are overpayments or prepayments. They are monies that have been paid on an
account but not distributed to services on the account. These payments can come from patient
payments, insurance payments or adjustments.
The first step in working with unapplied balances is to determine how the money was placed into the
unapplied balance area. This can be determined in three different ways.
1. Patient Transaction Summary Tab – Click on the Ellipsis button next to the Unapplied Balance.
The comments area will state how the money was placed into Unapplied Balance.
1 2. Patient Transaction History Tab – Click on the Ellipsis button next to the Unapplied Balance. The
comments area will state how the money was placed into Unapplied Balance.
3. Unapplied Monies Report – This report will show all unapplied balances in the PTOS System.
The description area will state how the money was placed into Unapplied Balance. Reports /
Transaction Lists / Unapplied Monies.
Example:
Account Balances and Unapplied Money
If the patients account has insurance attached that is paying 100%, the account balance will be
$75.00 and the patient balance will be -$25.00 if they make a payment.
Note: Balances will differ depending on the percentage the insurance is set to pay.
Applying Unapplied Money
2 The location where the original payment was posted will determine where to go in the system to apply
the unapplied balance. If they payment was posted in the “Account Payment” tab, the unapplied
balance will appear in the Account Payment tab.
Example – Applying Unapplied Money from the drop down
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Go to the correct tab. If applying a patient payment – Account Payment Tab; if applying
an insurance overpayment- Insurance Payment Tab.
Double-click on the correct overpayment in the dropdown.
The payment fields such as date and type will populate automatically based on the
information entered in the original payment.
Apply the entire amount or a portion of the overpayment to the service lines
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Any portion not posted will stay in the unapplied balance area until used.
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Example – Applying Refunds
To refund the patient, go to Payments/Adjustments – Adjustments Tab
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Choose the Adjustment Date
Choose the Adjustment Type (Patient Refund – impacting Patient Payments)
Choose Debit Adjustment (Increase Balance) – This is essentially adding a balance
back onto the account because you took away a payment that was made.
Enter a comment as to why there is a refund
From the dropdown, choose the unapplied Payments and double-click on the
overpayment to pull in. If not all will be refunded, enter the actual refund amount in the
“Amount” field.
Update the adjustment
3 Overpayments – this is the largest new feature of PTOS 5.5.
When an overpayment was received in previous version of PTOS, you likely had to create two
separate manual transactions – one to apply the insurance payment up to the charge amount and a
second to create a separate credit for the overpayment amount.
PTOS 5.5 now reduces the number of steps to handle overpayments. It allows you to distribute the
insurance payment to the charge/claim that exceeds the balance and automatically creates an
unapplied credit for any portion that exceeds the balance.
The system prioritizes previous credits that have been applied to a charge. It unapplies them in the
following order to allow room for the insurance payment to be applied:
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Patient Payments
Adjustments Impacting Adjustments
Adjustments Impacting Charges
Adjustments Impacting Patient Payments
Adjustments Impacting Insurance Payments
• Unapplied according to insurance priority level, with primary being unapplied last.
• Insurance Payments
• Unapplied according to insurance priority level, with primary being
unapplied last.
4 The Overpayments will
display in Orange on your
screen.
You will also see a notation about the
Overpayment displayed in Orange at the
bottom of the payment screen.
You can apply Insurance Overpayment for an Individual or from the Bulk Insurance Payments.
Bulk Payments Window. In this screenshot you can see the Overpayment in Orange.
5 Reports
Unapplied Monies – This report will allow you to track the unapplied balances in the PTOS system.
Transaction Audit Trail - This report will show you all transactions within a specified range.
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