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How to resolve unallocated insurance payment amounts

How to resolve unallocated insurance payment amounts

Watch this video series to learn how to resolve insurance payments with unallocated amounts, including how to locate the insurance payments, determining the cause of the unallocated payment, and the steps for resolving unallocated payments


Locating unallocated insurance payments

To locate an insurance payment with an unallocated amount, follow these steps. 


Common scenarios with unallocated payments

Below are several common scenarios where you may find an insurance payment that has an amount in the unallocated field, along with how to resolve them.

You also can learn more about properly allocating insurance payments as well as how to investigate unallocated payments:

Deleted appointments

In this scenario, an appointment was deleted from the calendar after the appointment was billed to insurance. This results in the system not being allowed to locate the appointment to properly allocate the payment amount.


Appointment moved

In this scenario, an appointment was dragged and dropped onto a different date on the calendar after the appointment was billed to insurance. For example, if the appointment was originally listed on the calendar on 12/18 but the appointment was later dragged to 12/21, it would result in an unallocated payment. When this happens, the system won't be able to locate the appointment to properly allocate the payment amount.


Appointments marked no show or late canceled

In this scenario, one appointment was marked as a No Show and the other appointment was marked as a Late Canceled appointment after the appointments were billed to insurance.


Claims deleted or submitted outside of SimplePractice

In this scenario, a claim was submitted and then deleted, or was submitted outside of SimplePractice. In both instances, a payment report is received, but the payment isn't able to allocate to a specific claim. 


Steps for resolving unallocated payments

To resolve an unallocated payment, follow these steps:

  • Go to Insurance > Payments and find the payment with an unallocated amount.
    • Compare the unallocated amount to the Insurance Paid amounts to see if the unallocated amount is the same as or a multiple of one of the Insurance Paid amounts.
    • Copy the check/wire transfer number and make note of the Payment Date.
  • Navigate to Reports > Payment reports.
    • Adjust the date range to match the Payment Date on the insurance payment. The Payment Date on the insurance payment is the same as the Date Received.
    • Use Command + F (Ctrl + F on PC) to search for the check/wire number. This will highlight all the payment reports associated with the insurance payments check/wire number.
    • Right click the Date Received to open each payment report in a new tab.
  • Review the Claim Details page.
    • The Payment Overview section shows the dates of services that are attached to this claim. Any insurance payment that's attached to the date of service will be listed. 
    • Review the Insurance Payment Report section. 
    • To find the discrepancy, compare the appointments and paid amounts on the payment report to what's listed for the insurance payment in question.
    • If any appointment is missing or a paid amount is incorrect on the insurance payment, you can update the insurance payment to reduce the unallocated amount. 
  • Repeat step three for each of the payment reports associated with the check/wire number.


Accessing the full EOB

If you're enrolled to receive Payment Reports, you’re also able to access the full EOB (Explanation of Benefits) within SimplePractice. This can save you time when investigating insurance payments with unallocated amounts


Best practices for allocating insurance payments

When a manual insurance payment is entered, you'll need to enter the full payment amount in the center column at the top of the page. This amount will now populate in the Unallocated field to the right of this column.

When you apply these payments to appointments, the unallocated amount will decrease as the payments are being allocated to various appointments. The unallocated amount serves as a reminder that part of the total payment has not been allocated to an appointment yet.

If there's a negative amount in the Unallocated field, it means you have allocated insurance payments in an amount that is greater than the total payment entered in the Amount field.

Based off the total payment you have entered, there are two reasons this can occur:

  • You haven't entered the full payment amount
  • You have allocated additional funds to appointments that aren't associated with the full payment

Tip: If you'd like to see exactly how the unallocated amount was calculated, add up all the amounts in the Insurance Paid column and subtract that number from the amount in the Amount field found at the top of the page.

Note: For more information on insurance accounting, see Insurance Accounting Best Practices.

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