Payments for CMS 1500 Forms (US only)

How to record payments for CMS 1500 Forms (Insurance Claims)

Updated over a week ago

Payments are located under the first section of a bill created in Kalix. Kalix supports the ability to add client copayment and readmittance information from primary and secondary insurance.
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Contents of this Article


View Payments

To view payments for a particular bill, first, you need to locate the bill. This can be done using two different methods.
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Client Cover Page

You can view a specific client's bills via their cover page (the first page of their saved file. Please scroll down to the subsection Billing, locate the bill you wish to view, and click on it to open.
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Billing 

You can also view all unpaid bills by clicking on Billing on the top header, followed by Overdue.

Find your bill, and click to open.
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Once you have opened the bill, the first section of a saved bill is Payments.
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Recording and Charging Copayments

To use this functionality, a copayment amount should be saved to the client's insurance details.

To record a client copayment, follow these instructions:

Scroll to the Payments heading and click on the New button. Then choose Manual Copay or Credit Card Copay.

Manual Copay

If you choose Manual Copay, the Add Payment window will pop up. Record the payment method and amount and click save

Credit Card Copay

Note: This option only appears if you have credit card payments enabled on your account.

After selecting Credit Card Copay, a pop-up window will appear. Click Charge Credit Card.

Select the credit card on file or enter a new card. Click Pay.


Adding Insurance Payments 

If you are using Kalix's Office Ally integration and you have electronic remittance advice (ERA) set up, payment information will automatically save into your Kalix account against each associated bill. The status of claims in Kalix will automatically update.


Kalix receives ERA only once a day from Office Ally in batches (payment details about multiple claims in one file).

The claims included in a remittance batch maybe not be the same claims that are sent together to Office Ally.


Incoming payment information can be viewed in the Remittance tab of the Batch page.

As a default, you will receive an email notification when a new remittance is received.

Click on a row to view the claims in the batch.

Next, click on a particular bill to view additional remittance information.

On the payment page, scroll down to the Payment section to see a summary. Click on menu (three dots, followed by edit, to view additional information.


Uploading Electronic Remittance Advice (835) For Availity to Kalix

Electronic Remittance Advice (or payment information) is sent back from billed insurers to your Availity Essential account.

While Kalix does not have a direct integration with Availity, you can upload received files ERA 835 files) from Availity into your Kalix account. Kalix will automatically save payment details, adjustments & error codes to the applicable bills.

1) To upload remittance, navigate to the Remittance section of your Created Batch page in Kalix.

2) Click on the Upload 835 button (see below) and select the 835 file from Availity.

3) Kalix will save all remittance information to their applicable bills.


Reconcile Payments

The payments will post including a Reference number. This number corresponds to the payment reference number you receive along with your payment information such as checks or electronic transfers.

When getting ready to reconcile your payments, you can click on the Billing tab, then click on bills and search each bill via the reference number.

Once you have found the bill you can either close it or change it to billing client if there is a patient responsibility.

If there is a patient responsibility, switch the status to Billing Client.

If you are ready to close the bill, simply click on the close bill button.

Note: To receive payment information automatically in Kalix, ERA must be set up by completing paperwork for each insurance company you bill.


Charging Clients the Outstanding Amount

If you want to charge your client the outstanding amount, scroll down to the bottom of the Payments page and click Share.

Select Send to email the client an invoice. If you are using integrated credit card charging, the client can pay by credit card online.

Choose Download to print out a copy of the invoice.

Click on the New button to manually record that the client paid the outstanding amount.


  

Closing Bills

You can close a bill at any time. Just click on the Close button as shown below. 

Note: bills can still be closed if money is outstanding, e.g., insurance pays less than the service cost. Kalix will automatically mark the bill as having zero dollars owing.
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