2. Payment Reconciliation
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Commonly used for reviewing and confirming insurance payments after claims have been transmitted, the Payment Reconciliation Report allows pharmacies to reconcile prescriptions and track which claims were actually paid by insurance; this report is frequently misunderstood as an editing or billing tool, but it is intended solely to confirm and track insurance payments rather than modify billing or payment amounts.
Payment Reconciliation
The Payment Reconciliation Report is used to manually process and reconcile prescriptions after claims have been transmitted, allowing pharmacies to verify which prescriptions were actually paid by the insurance company and for which funds were received. Through this reconciliation process, prescriptions included in the report update from a status of Transmitted to Paid by Insurance, helping pharmacies clearly distinguish between claims that were submitted and those that resulted in payment.
To access the Patient Reconciliation screen, click on Billing 2. Payment Reconciliation.
To reconcile payments, select the appropriate From Date and To Date to define the reconciliation period.
Reconciliation Filters
Plans: You may optionally type and search for a specific Insurance Plan to narrow the report to prescriptions associated with that plan or insurance plan group; to view all payment reconciliations, leave the Insurance Plan field blank.
Display Acq Cost: Choose Yes or No to include acquisition cost on the report.
Display Drug: Choose Yes or No to display drug information.
Statuses to Display: Select Transmitted (not reconciled), Paid‑By Ins (reconciled), or Both Transmitted & Paid‑By Ins to control which prescriptions appear.
Once your selections are made, click Generate Report to display the prescriptions available for reconciliation.
Reconcile Payments
To reconcile prescriptions, click anywhere within an individual prescription row to select it, or use the Click here to Reconcile All checkbox to select all listed prescriptions at once. As prescriptions are selected, the Reconciling Totals section will update dynamically to reflect the selected amounts.
If errors occur during reconciliation, check the Rx # in the Payment Reconciliation Report to confirm whether it was already auto‑reconciled, indicated by a Paid by Insurance status.
When ready, click Reconcile or press Enter while the Reconcile button is highlighted to complete the reconciliation process; reconciled prescriptions will update from Transmitted to Paid by Insurance, indicating payment confirmation.
SDRA added to Payment Reconciliation screen
The MFP SDRA has been added to the payment reconciliation screen.
Printing
To print the report, click Print or press Enter when the Print button is highlighted.
To export the report, click Export Data or press Enter when the Export Data button is highlighted. Note: Export to Excel requires a full version of Microsoft Excel or Office and does not work with Office Starter 2010 or other starter or third‑party versions; use CSV export instead.
To clear all displayed data, click Cancel or press Enter when the Cancel button is highlighted.