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A typical Monday morning

A story of one remittance through Ordo. The numbers are realistic but fictional. Use it as a picture of “what good looks like,” then follow the click-by-click version in Post a payment.

7:45 a.m. — The PDF arrives

Cigna’s weekly remittance lands in Jennifer Park’s inbox: Cigna_Remit_Aug24.pdf. Three patients are on it, including Maria Santos (exam + cleaning, plan covered $142.00).

Jennifer makes coffee, opens Ordo, and glances at the sidebar: Actual. Not Demo. These are real patients.

7:52 a.m. — The inbox

She opens EOB Dashboard. Last week’s files are Posted. She clicks Upload EOBs, drops the PDF, and waits. Status moves Extracting → Extracted. The row shows 3 patients, 3 claims, 8 procedures.

She does not post yet. She messages Mike: “Cigna is in the inbox.”

8:10 a.m. — Fetch, don’t guess

Mike opens the file, ticks all three patients, clicks Fetch Open Dental. He starts with Maria.

  • EOB Review: Maria Santos, June 12, D0150 $42, D1110 $100.
  • Open Dental: recommended claim 18421, same date, both codes Match.
  • Audit: all signals pass.

He types a line remark on the cleaning: Cigna paid $100. He clicks Approve match. He does not have Post payment — by design.

James Lee’s recommended claim is last year’s visit. Mike picks the June claim from the candidate list, checks Audit, approves.

The third patient is Needs review: two people named Patel with overlapping dates. Mike opens Audit, rejects the wrong candidate, and leaves a payment remark: Two Patels — confirmed DOB with front desk. He will come back after Jennifer checks the chart.

8:40 a.m. — Post the easy ones

Jennifer filters the file to Approved, opens Maria, clicks Post payment. Confirmation with a claim payment number. Same for James.

Patel is still waiting. They will not rush a hard mismatch.

9:00 a.m. — Someone asks at the desk

Maria is at the front desk: “Did Cigna pay my cleaning?” Alex (Viewer) is covering phones. He does not know the file name. He opens Patients, types Santos, sees Posted, and can tell Maria yes — without having a Post button he could click by accident.

12:30 p.m. — The leftover

Front desk confirms Patel’s date of birth. Mike fetches again, selects the correct claim, approves. Jennifer posts.

The file’s patients are all Posted. Jennifer leaves it in Active until Friday in case Cigna sends a correction. Next week she may Archive it so it stops cluttering the inbox. Posting Analytics will still have counted it while it was active; after archive it drops out — so she archives after the owner has seen Friday’s numbers, not before.

1:00 p.m. — Was it the right amount?

Before lunch ends, Jennifer opens the Cigna file’s Payment Analysis tab and clicks Run analysis. One line is flagged: Maria’s cleaning, Potential underpayment, $15. How calculated shows Cigna’s contract is $100, Maria’s share is $20, and Cigna paid $65.

She opens Maria → Payment Analysis → Review, picks Confirm Underpayment, and writes “Called Cigna 3/9, ref #44821.” The payment was already posted; the review is a separate follow-up.

Friday 4:00 p.m. — Analytics

Sarah opens Analytics → Posting Analytics, clicks Load overview, picks last 7 days and all EOBs. Posted count includes Monday’s Cigna. Failed jobs is zero.

Then she opens Payment Analytics → Remittances, clicks Load saved results, and sees the open underpayment work items for the week — including Maria’s $15, now marked Confirmed. She does not need to open Maria’s claim unless a dollar looks wrong.

What to copy from this story

  1. Check Actual before uploading real PDFs.
  2. Fetch before opening patients.
  3. Approve and post can be two people.
  4. Stop on hard mismatch / two similar names.
  5. Patients module is for “where is this person?”
  6. Posting a payment and checking it was the right amount are two separate steps. Payment Analysis does the second.
  7. Analytics is for the week, not for arguing with a patient at the window.