📮 EOB Creation & Portal Checks

The EOB Creation page is your headquarters for manually uploading remittances to your claims.

If you find yourself in possession of an EOB for an unreconciled claim, this is the tool you’ll use to update the claim status in Insights. It also accepts data from payer portal checks and good old fashioned calls to the payer.

We will refer to all manual remittance types — EOBs, Payer Portal Checks, and Payer Calls — as ‘EOBs’ in this guide.

Here’s how to upload a new EOB:

When you land on the EOB Creation page, you will see six tabs indicating the status of the EOBs listed:

Within any of these tabs, use the Multi-Search function to filter the EOBs listed by EOB ID, insurance, check number, patient name, or file name.

You can also click the ‘Actions’ menu to either view or delete a file.

Assuming you’re starting from scratch, click the ‘Post a New EOB’ button to get started.

Select the type of EOB you’ll be importing. Upload the file and then click ‘Continue.’

Next, you can use the search filters (Patient, Date of Service, Multi-Search) to find the claim(s) you want to link to the EOB. Then click ‘Add to EOB.’

Repeat this process until you’ve added all the claims you want, then click ‘Process EOBs.’

Now it’s time to fill in the key data from the EOB.

Keep an eye on your count of validation errors next to the submit button. This keeps a live tally of issues that need to be resolved in the EOB.

Moving your cursor over this note will provide a list of the specific patients’ claims where the issues are located.

Find the patient/claim with an error, indicated by red ‘Information’ icons. You can then hover your cursor over the icon to the right of the CPT code description to discover what the specific issue is and rectify it.

If your EOB contains an adjustment that doesn’t fall into the most common categories, you can add a custom adjustment using the ‘Add Adjustment’ button.

This is most often needed for Denials.

Clicking the button will add a new row to your EOB to hold the custom adjustment:

Here you’ll enter the following data:

Continue to fill in remittance data for each procedure in the claim. As you go, our tool will be watching for inaccuracies and give you feedback in two ways:

Once all the remittances are filled in, proceed to the next claim and continue until the data for each claim has been completed.

If everything has gone as planned you should now see a visual indicator that all validation checks are passing. If they’re not, this is a good moment to quickly check your work.

Occasionally an EOB will truly contain data that fails validation checks. If that happens don’t worry, you can still submit your EOB!

Click the ‘Submit’ button in the upper right of the page, and a window will pop up to request your final confirmation.

Hit ‘Confirm’ to finalize your submission.

The EOB will take a few moments to submit each claim linked to your EOB. For large numbers of claims this may take as long as half a minute.

Once submission is complete you’ll be shown a confirmation message, then redirected back to the main EOB page. Success!!

And that’s it! New EOB data will show up on your claims within 24 hours.

While that data is processing, claims included in the EOB will be marked with a notification so your team knows that updates are in progress.

No, uploading a file or screenshot is optional (but it’s strongly encouraged for record keeping).

You can upload an EOB, data from a Payer Portal check, or info from Calling a Payer.

Yes! EOBs intended for processing by the Athelas team should be bulk upload via this tool, which is monitored by the Athelas remittance team.