How to Post ERA and EOB Insurance Payments in Office Ally
Short answer: To post an insurance payment from a remittance, choose Insurance rather than the manual posting path, choose the EOB and ERA option, enter the insurance company's name, and locate the payment that came in. Click View EOB and ERA to read the remittance, search for the patient, select the patient and apply the payment. If a balance remains, click patient responsibility, enter your message in the popup, and generate the patient statement from that same screen. Then go to Reports, Manage Billing Statements to pull the batch that needs printing and mailing.
What this screen is actually asking you to decide
Once you sign up with your various payers and insurance companies to have the explanation of benefits sent directly into Office Ally as electronic remittance advice, the remittances arrive here. Without that setup, everything on this screen has to be entered by hand instead.
The remittance tells you three things. What was paid, what was contractual, and what belongs to the patient. Autopost makes that third decision for you, and it has a habit of writing off patient responsibility, including deductibles and other amounts you should be sending a statement to the patient for. Posting deliberately keeps the decision with you.
The steps
Sign up with your various payers and insurance companies first, so the explanation of benefits comes into Office Ally as electronic remittance advice.
Choose Insurance rather than the manual posting path.
Choose the EOB and ERA option. This pulls in the remittances that have arrived.
Enter the insurance company's name. This step is required.
Locate the payment that came in.
Click View EOB and ERA. The remittance opens.
If you work with two screens, move it to the second screen and enlarge it so you can read it.
Read it before you post anything. This is where you see what was paid, what was contractual, and what belongs to the patient.
Search for the patient.
Select the patient.
Apply the payment.
If a balance remains, click patient responsibility.
A popup appears. Enter your message in the popup.
Generate the patient statement from this same screen.
Go to Reports.
Go to Manage Billing Statements.
Pull up all of the statements that need to be printed and mailed.
Why the order matters
The whole workflow is built to be done in one pass, from posting through to the mailing list, and it only works if you finish it. Applying the payment is not the end of the task. The task ends when the remaining balance is marked as patient responsibility and the statement exists. Stop halfway and the payment is posted while the balance sits unmarked, so it never reaches a statement and never gets billed, and whoever fixes it later has to reopen a remittance nobody remembers.
The mistake this prevents
The expensive habit is letting autopost decide what is patient responsibility. Autopost has a habit of writing off patient responsibility, including deductibles, so amounts the patient genuinely owes are adjusted away rather than flagged for a statement. The balance does not age, it disappears. Nobody chases it because nobody can see it, and the practice never learns what it gave away. If you do use autopost, you have to go in and check every posting afterward, and checking every posting takes as long as posting deliberately would have.
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Marie Matteson, MS, is a healthcare consultant, educator, and Office Ally specialist with more than 30 years in healthcare, emergency medicine, and practice management. Helping you understand what's really going on.
All patient information referenced here has been redacted. This content is educational and is not billing, legal, or coding advice. Always follow your payer contracts, your practice policies, and current coding guidelines. Not affiliated with or endorsed by Office Ally.
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