How to Post a Patient Payment in Office Ally
Short answer: Open the patient's account and apply the payment. Change the payment type to Patient Payment, apply it to the correct visit, and change the status to Patient Responsibility, because that is the only way the patient is going to get a statement. Enter your adjustment, meaning the insurance write off, on that same screen. Then choose to apply the payment and generate a statement, write the message the patient will read, and choose Generate and Print to send it to your printer now or Generate on its own to print everything in one batch later, then click Update.
The one field that decides whether a statement ever exists
A patient pays, you post it, and the screen looks finished. The payment is recorded and the visit is updated. Nothing tells you that the remainder is going nowhere.
Changing the status to Patient Responsibility is the only way the patient is going to get a statement. It is not a label, it is the trigger. Leave it alone and the balance sits on the account looking healthy while nobody ever bills for it.
The steps
Open the patient's account.
Apply the payment.
Change the payment type to Patient Payment.
Apply it to the correct visit. Choose the specific date of service the payment belongs to.
Change the status to Patient Responsibility.
Enter your adjustment, meaning the insurance write off or contractual adjustment. The write off is entered on this same screen.
Choose to apply the payment and generate a statement.
Write the message the patient will see. Common options are your insurance has applied to your deductible, or insurance has paid its portion. You can also write your own, such as thanks for your payment.
Choose how to output it. Generate and Print sends it straight through so you can send it to your printer now.
Generate on its own saves it so you can print everything in one batch later.
Click Update. This returns you to the payment screen.
If you are working from checks and remittances
Go to Add a New Payment or Deposit and check whether there are any checks waiting for autopost. If a check is there, the check number appears automatically and you enter the check name, then choose your patient and apply the payment to that patient. Click View EOB and ERA to read the remittance while you post. That requires that you have set up automatic electronic remittance advice with the insurance company, which you do by going into the forms for Office Ally and checking what your particular insurance companies require. Once connected, the remittances arrive directly in the system, so you are not waiting for paper in the mail and not logging into a separate portal to retrieve them. The remittance shows the patient name and where to apply the payment. If you have two screens, keep the remittance on one and post on the other.
Why the order matters
Post the payment, enter the insurance write off or contractual adjustment, then generate the statement. Generate first and the statement reflects the balance before the contractual adjustment was taken, which means the patient receives a bill for money they do not owe. Payment, adjustment, message, then generate.
The mistake this prevents
The most consequential mistake here is not setting Patient Responsibility, and it does nothing to announce itself. Post the payment, leave the status alone, and everything on screen looks correct. No statement will ever generate for the remainder, because Patient Responsibility is what moves a balance into the statement queue. The patient is never billed, the balance ages quietly, and months later it shows up in the over ninety column looking like a collections failure. Nobody made an error anyone can see. Somebody skipped one dropdown. Set it before you apply, every single time.
More Office Ally training
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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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