Medicaid claims post to the general ledger at two points: each night as service days accrue, and when you save the payer’s remittance (835). Unlike invoices, revenue posts as days accrue, before a claim is sent. This guide gives an overview of what posts, when it posts, and how changes, payments, and voids affect the ledger.
Note: Values and examples in this guide follow California Medi-Cal requirements.
About Claim Postings
Invoice billing posts to the ledger when an invoice is created. Claims billing has no invoice, so ALIS posts each billable service day as it accrues, even before the day is exported on a claim. This keeps revenue and receivables current for residents billed by claim.
The two postings work as a pair. Each night, service days raise Accounts Receivable. When a payment is saved, it lowers Accounts Receivable and records the cash.
| When it posts | Debit | Credit | Shown in GL Transactions as | |
|---|---|---|---|---|
| Service days | Each night | Accounts Receivable | The billing item’s revenue account | Claim Charge: Added |
| Payments | When you save an 835 | Primary Deposit | Accounts Receivable | Claim Payment: Added |
GL Accounts Used
- Revenue: Set on each billing item’s GL Account field.
- Accounts Receivable: Set on the claims payer type, under AR.
- Primary Deposit: Set on the claims payer type, under Cash.
If an account isn’t mapped, the entry still posts, but shows the account type name (“Revenue,” “Accounts Receivable,” or “Primary Deposit”) instead of a number. These entries can’t be updated later, so map all three before service days start posting. See How to Set Up Medicaid Claims Billing, Steps 3 and 4].
Each Night: Service Days Post
Each night, ALIS posts every new billable service day: debit Accounts Receivable, credit revenue. The amount is the day’s Unit Price × Quantity. Clicking Sync now on the Billing Queue also posts new days right away.
- Held days still post: A hold keeps days out of the Billing Queue, but their revenue still posts each night.
- Posting doesn’t depend on export: A day can be posted and still waiting in the Billing Queue.
- Each day posts to its own service month: If that month is closed, the day posts to the current month instead, or the next month that isn’t closed. A month in restricted close still accepts postings.
- A day can’t post if its billing item isn’t set up for the community: It’s skipped, and the run’s Audit tab entry counts it as not posted.
Tip: Post and review claim charges before closing a month. Days that post after the close are moved to a later month.
When Service Days Change
When a day’s amount changes or a day is removed before it’s billed, ALIS corrects what already posted in the same save.
| Change | What posts | Shown as |
|---|---|---|
| A recurring charge’s price or quantity is edited | The difference between the old and new amounts, for unbilled days only | Claim Charge: Edited |
| A rate change (including bulk and import) covers days already posted | The difference, as days move to the new rate | Claim Charge: Edited |
| A leave or Billing Center event rule removes days | A reversal of what those days posted | Claim Charge: Deleted |
| A recurring charge is deleted | A reversal of its posted, unbilled days | Claim Charge: Deleted |
| Days return to the queue (Return to Queue, Delete Batch, or Void) | A correction only if the rate changed while the days were on the claim | Claim Charge: Edited |
Reversals always use the amount that actually posted, even if the charge’s price has changed since.
Important: If a correction’s service month is closed, the closed month keeps the original amount and the difference posts to the current month. A GL export already sent for the closed month isn’t updated, so the difference appears only in the later month.
When You Save an 835: Payments Post
Saving a remittance posts the payment: debit Primary Deposit, credit Accounts Receivable.
- One entry per resident per file: A resident with more than one claim in the same 835 gets one combined entry.
- Dated in the current month: Not the service month or the 835’s payment date, even if the service month is closed.
- Only claims paid in full post: Denied, partially paid, overpaid, and not fully reconciled claims post nothing, and their Accounts Receivable stays open. This includes contractual adjustments, where the payer pays less than billed by agreement.
- Uploading alone posts nothing: A remittance marked not yet saved hasn’t touched the ledger.
See How to Post a Clean Medicaid Payment (835/ERA).
When a Claim Is Voided
Voiding a denied claim is recorded in ALIS only. The void itself posts nothing to the general ledger. Its days return to the Billing Queue with the revenue they already posted. If the rate changed while the days were on the claim, they move to the current rate, and the difference posts as Claim Charge: Edited.
If a payer later pays a voided claim, the payment doesn’t post. Reconcile Remittance shows “Paid after void. Not posted; a recoupment is likely.” Handle the cash outside ALIS.
See How to Generate Claims and Correct Rejected or Denied Claims.
What Doesn’t Post Yet
- Partial payments and contractual adjustments: No entry posts for the paid portion or the write-off.
- Recoupments and payer reversals: Not handled in ALIS.
- Editing or deleting a claim payment entry: Not available.
Where to See Claim Postings
- GL Transactions: Filter by the claim charge and claim payment activity types.
- Aging Report: Shows claim balances, including the Unsubmitted amount for days posted but not yet exported. See Medicaid Claims Reports.
- Medicaid Billing > Audit tab: Records each posting run, skipped payments, and voids.