Using Insurance Payments
Updated at May 8th, 2025
Table of Contents
The Insurance Payments dashboard is available for clients that wish to process virtual credit card (VCC) payments as reimbursement from the payer. VCC payments are typically processed faster than traditional checks, improving cash flow. And they reduce fraud due to their one-time use. VCC payments generally fall into two categories:
-
C2B (Consumer to Business): The consumer (patient/guarantor) makes a payment to their provider via their payer/health plan portal. The payer is reimbursing the provider for a patient payment. PatientPay would process these as bill payments. If we're unable to match a bill for the patient's account, it will be processed as a Now payment.
- B2B (Business to Business): The health plan reimburses the provider for a claim (e.g., Workers Comp). PatientPay would process these as insurance payments.
PatientPay Accelerate
PatientPay Accelerate offers fully automated VCC payments via Optum© Straight Through Process (STP), as well as manual VCC payments for providers that are not enrolled in this service. Once the provider is enrolled via Admin Configuration, PatientPay will receive VCC transaction data, process the payments automatically, and reconcile the payments back to the provider as with all payments. The provider no longer gets VCC remittance via postal service, email or fax. And they do not have to manually enter VCC card information or manually reconcile the payments.
To learn more about automating VCC payments, please contact your PatientPay account manager.
Insurance Payments Dashboard
The Insurance Payments Dashboard is provided for organizations that are enrolled in fully automated VCC payments using Optum's Straight Through Processing (STP). This is used to review transactions as they come through PatientPay and are either rejected or processed successful. The user can filter by the practice(s), status and time frame. The status filter includes Pending Approval, Processed, Rejected and Failed.
Figure 110 - Insurance Payment Dashboard
Below is the list of each column in the dashboard:
| Column Name | Description |
| Created Date | The date the transaction was received from the VCC issuer (Optum) |
| Practice Name | Practice name to which transaction is being reimbursed |
| Status |
The current status for the transaction: -Invalid provider TIN -Unable to match patient account and feature flag ALLOW_NOW_PAYMENTS = false so we didn’t create patient account -Unable to match bill and feature flag ALLOW_NOW_PAYMENTS = false so we didn’t create Now Patient Payment -Matched bill but balance in PatientPay is $0
Processed - Processed VCC payment successfully |
| Type |
Identifies the type of transaction: Patient - C2B (Consumer to Business) that represents a reimbursement to the provider for a patient/guarantor payment to the payer/health plan. Insurance - B2B (Business to Business) the represents a reimbursement to the provider by the payer/health plan for a claim. |
| Payer/Patient | Represents the payer (B2B) or patient name (C2B) from which this transaction is reimbursement for |
| Transaction Number | Unique transaction number for this VCC transaction |
| Payment Date | The payment date |
| Amount | The payment amount being reimbursed |
| Transactions | The count of transactions in this VCC batch |
| Card Last Four | The last four digits of the VCC used to identify the card |
| Card Expiry | The expiration date of the VCC in format MM/YYYY |
Transaction Detail
To view the details of any transaction, click the View button to the right of each row and it will display the Transaction Detail screen.
Figure 111 - Transaction Detail
The user can return to the Insurance Dashboard by selecting the breadcrumb hyperlink in the top of the screen. The header displays the selected VCC transaction's Payer/Patient name (patient name for C2B and payer name for B2B), Transaction Number, Payment Date and Amount. If the issuer provides a phone number for claims questions, it will be displayed in the upper right. The list will show all transactions for this VCC card (Optum has 1 transaction per VCC). That listing will show the following columns:
| Column Name | Description |
| Payment Status | The current status for the transaction (same values as Dashboard). If Rejected or Failed, hover over the status to get a tooltip with the response code and message explaining why. |
| Patient ID | The patient account number for the patient whom is receiving the payment (for C2B) |
| Patient Name | The name for the patient whom is receiving the payment (for C2B) |
| Date of Birth | The date of birth for the patient |
| Claim Number | The claim number to which the reimbursement applies (B2B) |
| Payment Amount | The payment amount |
If the transaction is B2B, the download icon will allow the user to download the EDI 835 document provided for the transaction. The Payment total in the lower right of the screen represents the sum of the transactions in the list that will be drafted using the VCC.
Fully-Automated VCC Payments
When enrolled in Optum STP VCC payments, the provider doesn't have to take any action. VCC transactions are automatically received by PatientPay daily, and the payments are drafted at 1PM EST the following day. This removes the burden on the provider to ensure they receive the remittance correctly (via USPS mail, email or fax), manually enter the VCC card details and payment, and reconcile back to the system of record.
PatientPay will create an Admin Bill Payment for every C2B transaction we receive that matches a patient account and bill in our system. If desired, transactions that do not match can create a Now payment and optionally tag the patient account (enabled by default). PatientPay will create an Insurance Payment for every B2B transaction we receive. This ensures that VCC payments made by PatientPay will reconcile with your existing merchant ID (MID) and post back to your system of record using existing processes. Insurance Payment transactions can use a separate merchant ID (MID) and separate Recon file, if desired.
Manual VCC Payments
For providers that are not enrolled in Optum STP VCC payments, and still want to accept VCC payments manually, simply choose the Enter Manual Insurance Payment hyperlink on the upper right of the Insurance Payments Dashboard.
You will be shown the Insurance Payment screen below. You can optionally provide the payment location and patient ID, enter the insurance company name, payment amount and description. Under Payment Method, you will enter the VCC card details from your remittance into the New Credit/Debit Card section and press Submit Payment. These are recorded in PatientPay as Insurance Payments and will reconcile either on the primary Credit/Debit MID or a separate Insurance MID (if configured).
Figure 133 - Insurance Payment