TriZetto: Track Claim Payments

Once integrated with TriZetto, PracticeQ receives remittance reports from your payers. PracticeQ then automatically closes the associated claims and creates a payment record containing the EOB details. 

Track claim payments

  1. Click Lists → Claims → Payments.
  2. You will see:
  • Claim amount
  • Amount paid by Insurance
  • Patient Responsibility
  • Line items for each claim and their respective amounts

Note: This page also allows you to enter payments manually, in case you work with a payer that does not provide ERA reports. For steps on how to do this, see related article Track Insurance Payments.

Invoice Automation Options

  • There are various options for how our system treats posted insurance payments and the associated invoice (or lack of an invoice). 
  • These options can be accessed under Lists → Claims → Claim Settings → Other.
  • Use these settings to automate client invoicing based on claim payments. The system can create or update invoices based on the client responsibility portion of claim payments. Here are the options:

When Claim Payment is Posted:

  • Do Nothing
  • Create Invoice And Do Not Sen
  • Create Invoice And Send

When Claim Payment is Posted, and Invoice already exists:

  • Do Nothing
  • Update Invoice And Do Not Sen
  • Update Invoice And Send

🛑 PLEASE NOTE: If you manually change the status of a claim to Paid it can also update associated invoices.

Notification

If you would like to receive a notification when an invoice is updated by a processed ERA, you can enable this under More → Settings → Notifications.

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