How To: Enter Insurance Payments


TherapyNotes' billing features allow you to keep a record of charges and payments for both insurance companies and your clients. After you receive a payment from a payer, record the payment in TherapyNotes.

If you are enrolled to receive electronic remittance advice (ERA) from a payer, TherapyNotes offers assisted ERA payment posting to help post the payment to your account. For detailed instructions, read How To: Post ERA Payments.

Role Required: Practice Biller

To manually enter an insurance payment:

  • Click Billing > Enter Insurance Payment OR Click Patients > Patient Name > Patient Billing tab > Enter Insurance Payment
  • Enter information about the payer, payment, and allocation


(A) Payment Type: Select whether the payment is from an in-network payer or an out-of-network payer. Your selection for Payment Type dictates which payers are available in the Payer dropdown

(B) Payment Amount: Enter the total amount of the insurance payment. By default, Payment from Payer is selected in the dropdown next to Payment Amount. This selection indicates that you are receiving a positive payment from the payer. If you are recording a refund paid to the payer, select Refund Paid to Payer from this dropdown. Selecting this option automatically sets the Payment Amount as negative.

(C) Items dropdown: The items dropdown below the payment information defaults to Submitted Items. If the insurance payment was meant for a specific service that is not visible in the table below, select another option from this dropdown. Submitted Items shows only items that have been marked as submitted in TherapyNotes and are awaiting payment from the payer. Open Items includes items that are pending submission to the payer in addition to submitted items that are awaiting payment. All Items includes all submitted and open items plus items that have been marked as paid.

(D) Allocation: Enter the amount of the insurance payment that should be applied to each date of service. 

(E) Adjustment: If the Allocation for a date of service differs from the Ins Amt, the exact value of the discrepancy will be shown in the Adjustment column. To accept the adjustment, select the checkbox next to the value. If the Ins Amt is set to $0.00, select the Approved checkbox next to the corresponding date of service to indicate that the claim was approved by the payer as indicated on the explanation of benefits (EOB) or ERA.

(F) Payment Adjustments: Enter the Description of Payment Adjustments and total Adjustment amount, if applicable. Adjustments may include bonuses from incentive programs, interest payments or charges, or deductions for prior overpayment, among others.

Quick Tip: To see additional information for each item, including the Patient Amount or Patient Balance, click the Select Columns link at the upper right corner of the table and select the checkbox next to the information you want to display.
  • Click the Save Payment button

What if the insurance payment is negative or zero?


Occasionally, a payer may send you an explanation of benefits (EOB) or electronic remittance advice (ERA) for a $0 payment. In these instances, a payer acknowledges the charge but will not reimburse you for the service, such as when a client has a deductible. 

To record a $0 payment, enter 0 for Payment Amount and 0 in the Allocation field for each corresponding date of service. To move the payment responsibility to the client, click on the hyperlinked date of service. For in-network items, enter the rate for the service in the Pt Amt field. For out-of-network items, enter 0 in the Coverage field. If you don't want the client to be responsible for the payment, select the Write Off Patient Balance checkbox next to Patient Paid.

Refunds and Negative Payments

A payer may require a refund or submit a negative payment in the event of overpayment, penalties, or other adjustments.

To enter a refund, select Refund Paid to Payer from the dropdown next to Payment Amount after the Payment Amount has been entered. This will automatically set a negative value for Payment Amount. Allocate the refund to the applicable dates of service by entering a negative value in the corresponding Allocation fields. A negative value can be entered with a minus (-) sign or surrounded by parentheses. For example, -20 or (20).

Negative payments may also be applied per date of service if the total Payment Amount is positive.

Have more questions? Submit a request


  • Avatar
    Shannon Jennings, PsyD, LMHC

    How do you indicate a claim was denied?

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    Please go to "billing" at the top of your TherapyNotes, and click on "edi claim history" to check for rejected claims. You will know if a claim is rejected after you submit it by going to the patient chart and if it says "resubmit edi" in green. You will then click on "edi claim history", it will say "rejected-new" in red. Please click that and it will tell you why it was rejected and who rejected it. If it says "payer" that is the insurance company, if it says "clearinghouse" then it is our clearinghouse emdeon. You will be able to fix the claim and resubmit it. Please let me know if you have any questions. Thank you!

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    Laura Roy

    how do I enter an insurance overpayment ?

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    We do not have this feature at this time, however what we would recommend is to input what the correct amount is (after the refund) for the payment and in the "check" field you will notate that there was a refund. This will help you stay organized should you want to see what happened to a certain payment from the past.You can also input any notes in the billing settings "billing comments" header of the patient chart. We will look in to adding this feature in the future.

    Please let me know if you have any additional questions or need further clarification. Thank you!

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    Katie Johns

    If I have an insurance payment of $0, how do I enter that? I've had it enter correctly before but occasionally when I go to the insurance payment page and enter $0 it does not take the amount and I cannot mark it as approved.

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    Go to the patient billing tab and click on "enter insurance payment" then under payment amount enter "$0", then under the payment allocation enter "$0", then you need to write off the insurance balance check off "write off ins balance. Once done click on "save payment". Please let me know if you have any questions. Thank you!

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    Rena Zerbini

    I submitted insurance payments into the system but did some by accident - how can i go back to review and edit? thanks!

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    Go to the patients chart, click on patient billing, then click where it says quick search: ALL ITEMS. You will then see the payment, click on the payment and on the top right hand corner click delete.

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    Sharon Alkire

    How do I enter an insurances adj? This is not a write off. Insurance Adjustments need to be kept separately from write offs.

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    This is something we plan on incorporating in the future but we do not have an eta, you can write a note in the billing comments in billing settings or under edi claim history there is a little note book next to each claim. Sorry for any inconvenience.

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    Mubbashir Khan

    If I recieved 2 insurance payments for 1 patient, Medicare primary and Medicaid secondary, but I only posted the primary payment, how can I go back and add the payment received for the second insurance?

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    Click on patient billing within patient chart, click on enter insurance payment, from the payer drop down menu select the secondary insurance, enter the payment amount and date. Then under the payment allocation for the date enter the amount paid and click on save payment. If you have any questions please contact support at 215-658-4550 or via email at

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    Phoebe Teare

    We are receiving huge EOB's from BCBS that are listed alphabetically and TN lists by date of service....WE WOULD LOVE to see a button at the top of the list of patients alphabetically...thanks so much!

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    Thank you for your feedback. We will forward your feedback to management for review. Thank you!

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    Nicolette Warner

    Will adding denials and reports for denials be added at some point?

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    The EDI Claim History makes it easy to track rejected EDI claims. Click BILLING > EDI Claim History. Then change the "Status" to "Rejected" or "Rejected - New", configure the date range, then hit search. You can add notes about the denial in each line item.

    You can also set each billing line item's status to "Rejected and Written Off". To do so, click PATIENTS > Click patient > "Patient Billing" tab > Click on date of service. Change the "Status" dropdown to "Rejected and Written Off". Save Changes. These items appear in the write-off report, which is found under BILLING > "Write-Off Report".

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    Sigmund Freud

    I'm with Phoebe on being able to sort by patient name when entering in our 30 page eobs...takes me forever to scroll looking for a name, would be much easier if we could sort alphabetically.

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    Thanks so much for your feedback! I will forward your suggestion to management for review. Thank you.

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    Regina Moore

    So, I am new to Therapynotes. I have been billing for 13+ years and I am completely stumped on a few issues but instead of filling up this page with issues I see as a licensed biller, Right now, I am wondering if I am doing something wrong. I have read all the threads here and it must be me. Here are a couple of my questions. I have submitted through EDI for primary insurance. I receive payment from the primary insurance and post the payment. Secondary payment is received and posted. When you click on the appointment date or even in the billing area, it looks as if entire payment is made by primary insurance only, why? Secondly, why doen't TN show when you need to submit a secondary? I have read the thread about going into the appointment and clicking update by each insurance prior to posting payment, but this does not work. Is there a tutorial or video that shows step by step instructions? I have worked on a few billing software in my day and the non placement of deductibles and co-insurance are an everyday part of billing. This should be added ASAP!!!!!

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    The only time you need to click the "Update" button is if you change the primary or secondary payer on the "Billing Settings" tab and need to apply that new payer to a billing line item that has already been submitted to insurance. Otherwise, there is no need to hit the "Update" link. Hitting "Update" does not post a payment, it only pulls the new payer onto the line item.

    The way you post a payment from secondary insurance is this:
    Click "Enter Insurance Payment", select the radio button for In- or Out-of-Network, the select the secondary payer from the dropdown menu. Then continue to fill out the payment amount and payment allocations as appropriate. Selecting the secondary payer when entering the insurance payment stores the payment under that secondary payer in the revenue report.

    At the moment TherapyNotes does not support submitting electronic claims directly to secondary payers. That is why TherapyNotes does not give such a prompt. We aim to support secondary EDI claims better in the future, however this is in the very early planning stages and we do not have an ETA on those improvements at this time. This article overviews secondary insurance in more detail:

    For more information on how to apply deductibles please see this article:

    For more information about how to handle coinsurance in TherapyNotes, please see this article:

    Please feel free to call the support team when you have some time to talk about this topic in more depth and walk through your issue. You can reach the team at 215-658-4550.

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    Heather Norman-Scott

    How do you document when insurance sends a payment via POS card. I see that I can choose externally processed cc but I don't know how to actually process the card without it looking like the client paid it or the client has a credit now.

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    To record this payment, Click Patients > Select Patient > Patient Billing tab > Enter Insurance Payment > For 'Payment Method' select 'Externally Processed Credit/Debit Card' > Enter payment information > Save. You can process this card through your Ignite Payments of Willow Grove account at You can do this through their point of sale by clicking on POS at the top right. If you have any questions, please contact our Support Team at 215-658-4550 or by email at Thank you.