--- title: How to record a payer payment or denial from a paper EOB description: "Record a paper or portal EOB on a claim: payment date, paid amount and the adjustment reason codes (CARCs), or mark the claim as denied." --- [Skip to content](https://support.pabau.com/en/pabau2/how-to-record-a-payer-payment-or-denial-from-a-paper-eob#main-content) [![pabau logo white](https://support.pabau.com/hubfs/pabau%20logo%20white.svg)](https://support.pabau.com/en/pabau2?hsLang=en) Open main navigation Close main navigation - [Get Support](https://pabau.com/support-center/) [Get Support](https://pabau.com/support-center/) Pabau Knowledge Base - There are no suggestions because the search field is empty. 1. [Pabau Knowledge Base](https://support.pabau.com/en/pabau2?hsLang=en) 2. [Insurance Billing](https://support.pabau.com/en/pabau2/insurance-billing?hsLang=en) 3. [Insurance Billing (US)](https://support.pabau.com/en/pabau2/insurance-billing?hsLang=en#insurance-billing-us) # How to record a payer payment or denial from a paper EOB Most payers send their decision back electronically as an ERA, and Pabau picks it up for you. Some payers only mail an explanation of benefits (EOB) or show it on their own portal. In this article, you will learn how to record what the EOB says on the claim, including the adjustment reason codes the payer uses to explain every dollar it did not pay, and what to do when the payer denied the claim. **NOTE:** Insurance billing is currently available for practices in the United States. You can record an EOB on a claim you have sent through Claim.MD that has not been settled yet. **Step 1: Open the Claim** Open the claim from **More → Claims** (it is usually in **Submitted**). Then: 1. Click **Record payer payment** at the bottom of the claim. ![Record payer payment on a submitted claim](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/489459989735-01-record-button.png) *Record payer payment on a submitted claim* **Step 2: Enter What the EOB Says** 1. Pick the **Payment date** from the calendar. You cannot save without it. 2. Enter the payer’s claim number from the EOB in **Payer claim ref (optional)**. With it, you can later void the claim or start an appeal from Pabau. 3. For each charge line, enter the amount the payer **Paid**. 4. If the payer paid less than you billed, choose the **Adj group** and the **Adj code** shown on the EOB. For a code that is not in the list, choose **Other code…** and type it (for example 45 or B7). 5. Enter the **Adj amt** for that adjustment. 6. Click **Record payment**. ![Record payer payment with the EOB’s amounts and reason codes](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/489459989735-02-eob-modal.png) *Record payer payment with the EOB’s amounts and reason codes* **IMPORTANT:** Recording the EOB settles the claim, so the claim moves to **Response received** and you can bill a secondary payer. It does not post the money to the invoice. To do that, click **Record payment** in the claim’s **⋮** menu, or post it on the **Remittance** tab. **Reading the Adjustment Codes** Each adjustment on an EOB has two parts: a group code that says who is responsible for the amount, and a reason code (CARC) that says why. | Group | What it means | | --- | --- | | **CO** | Contractual obligation (write-off). Your contract with the payer says you cannot bill the client for it. | | **PR** | Patient responsibility. The client owes it, for example a deductible, co-pay or coinsurance. | | **OA** | Other adjustment, when neither CO nor PR applies. | | **PI** | Payer-initiated reduction, made by the payer outside your contract. | | **CR** | Correction or reversal of an earlier payment. | Some reason codes you will see often: | Code | What it means | | --- | --- | | **1, 2, 3** | Deductible, coinsurance and copay amounts. Usually with PR, so bill the client. | | **45** | Charge exceeds the fee schedule or contracted rate. Usually with CO, so write it off. | | **16** | Claim lacks information needed for adjudication. Fix the claim and send it again. | | **18** | Duplicate claim or service. | | **29** | Time limit for filing has expired. | | **50** | Not deemed a medical necessity by the payer. | | **96** | Non-covered charge. | | **197** | Precertification or authorization absent. | | **252** | An attachment or other documentation is required. | Every reason code in the **Adj code** list shows its meaning beside it. **When the Payer Denied the Claim** If the EOB or the payer’s portal says the claim was denied: 1. Open the claim’s **⋮** menu. 2. Click **Mark as denied**. ![Mark as denied records a denial received outside Claim.MD](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/489459989735-03-mark-denied.png) *Mark as denied records a denial received outside Claim.MD* The claim moves to **Denied** and becomes editable again. Then either: - **Correct and resubmit**, if the denial was caused by something on the claim, such as a wrong code, a missing modifier or a missing authorization number. Fix it and send the claim again. - **Appeal**, if you believe the payer is wrong. Once the payer’s claim number is on the claim (from an ERA, or from **Payer claim ref**), an **Appeal** button opens Claim.MD’s appeal form for the claim. - **Bill the client**, if the service is not covered and the client agreed to pay. **TIP:** Do not send a denied claim again unchanged. The payer will deny it again, often as a duplicate (reason code 18). **What's next?** - [Understanding claim statuses on the Insurance claims list](https://support.pabau.com/en/pabau2/understanding-claim-statuses-on-the-insurance-claims-list?hsLang=en) - [Submitting secondary claims in Pabau](https://support.pabau.com/en/pabau2/submitting-secondary-claims-in-pabau?hsLang=en) - [When a payer reverses a payment](https://support.pabau.com/en/pabau2/when-a-payer-reverses-a-payment?hsLang=en) - [Automatic checks for new remittances (ERAs)](https://support.pabau.com/en/pabau2/automatic-era-checks?hsLang=en) --- Was this guide helpful? Let us know by voting below - your feedback helps us write clearer articles. For **[more guides](https://support.pabau.com/en/pabau2?hsLang=en)**, browse the related articles below or use the search bar at the top of the page. 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