Liu Huang was seen for an outpatient visit at the Central Clinic and received a glenohumeral joint injection during the appointment. A claim was created for this visit and procedure and submitted to Lius insurance company. The insurance company provided Central Clinic with the below Explanation of Benefits (EOB) indicating what they covered, and they also submitted payment for their share through Electronic Fund Transfer (EFT). Review the submitted claim under the Account section of Lius chart. Then update the ledger to indicate the insurance adjustments and payments.

Additional info

Liu has met his annual deductible. Any Provider Charges that exceed the insurance companys Allowed Charges were discounted and adjusted by the insurance company neither the insurance company or the patient will be responsible for any amount exceeding the Allowed Charges in this situation and the provider will not receive payment for this amount. The insurance company then pays 80% of the Allowed Charges, and the remaining 20% is Lius responsibility as coinsurance.

The Discounts can be entered as adjustment transactions from the insurance company as a credit without a balance transfer.

The amounts Paid by Insurer can be added as payor payments via EFT.

The amounts owed by Liu as Patient Responsibility can be entered as an adjustment with a transfer balance from the insurance company to the patient. The transaction is for a credit for Patient Responsibility: Coinsurance.