Manual payment posting

Outcome

Payments that arrive outside an 835 — patient checks, paper EOBs, cash, refunds — are posted to the right claim with the right adjustments, with a clean audit trail.

Prerequisites

Scope	What it lets you do
billing.payment.read	See the Manual posting page
billing.payment.write	Post and reverse

When to use this

Source	Use this flow
Patient mailed a check	Yes.
Patient paid by card at the desk	Yes (if your tenant integrates the card processor, the entry is automatic — check before manual).
Paper EOB + paper check	Yes — but consider 4.1 — manual ERA upload if a corresponding 835 exists.
Refund (you owe back to patient)	Yes — reversal flow.
Payer payment outside 835	Try manual ERA upload first; fall back to manual posting.

The page

/payments/manual is the entry surface. Top-level fields:

Field	Meaning
Date received	Payment receipt date.
Payer / Patient	Pick — payer for insurance, patient for patient.
Method	Cash, check, card, ACH.
Reference	Check number, transaction ID.
Amount	Total.
Notes	Free text.

Steps — patient payment

1. Open Patient mode. Search for the member.

2. Pick the claims to apply against. The right rail shows open patient AR lines with balance. Apply the payment in any combination of:

   • One claim, full balance.
   • Multiple claims, partial each.
   • Unallocated (rare; usually you allocate immediately).

3. Save. The platform writes a payment row + per-claim payment_application rows. Each claim's patient AR balance reduces.

Steps — payer payment without 835

1. Open Payer mode. Search for the payer.

2. Enter the payment header (date, method, reference, amount).

3. Apply per claim. For each claim:

   • Pick from the candidate list (search by claim ID, payer claim control #, member, DOS).
   • Enter Allowed, Paid, and any Adjustments (CARC list).
   • The platform records each like an 835 line — same downstream effects (denial generation, COB triggering).

4. Save and post. Patient liability auto-routes; secondary auto- builds; denials emit. Same downstream as an 835.

Refunds

For patient refunds:

1. On the patient's account, click Refund. Pick the source payment or specify unallocated.

2. Confirm method (the platform usually defaults to the original method). Save.

3. Cut the check / process the card outside the system. Mark the refund row ISSUED and attach the reference.

For payer takebacks (PLB on a future 835), you don't post manually — the next 835 carries the PLB and the system reconciles.

Validation

Check	Expected
Payment applies to claim balances correctly	Yes — sum of applications = payment amount.
Patient AR reduces by the patient-side amount	Yes.
Audit log captures actor, method, reference	Yes.
Refund flips the claim's payment to REFUNDED	Yes.

Troubleshooting

Symptom	Cause	Fix
Save fails with over_application	Sum of applications exceeds payment	Re-check applications; reduce to match.
Patient AR doesn't update after save	Cache lag	Refresh the member detail.
Cannot find the claim in the picker	Cross-facility filter	Toggle Show all facilities.
Refund stuck at PENDING	The platform requires confirmation of issuance	Mark ISSUED with reference once the check clears / card reverses.

Where to next

• 7.1 — Patient liability routing — how patient-side amounts behave downstream.
• 7.4 — Write-offs vs adjustments — when the right move is a write-off, not a posting.