Applying Contractual Adjustment
GO TO
BILLING → VIEW CLAIMS → SEARCH CLAIM ID → POST PAYMENT
STEPS
- Enter the allowed amount in the allowable field as seen in the EOB
- A line item will then be populated showing this adjustment
- To Zero out the balance for amount owed by insurance, adjust the amount as contractual
- User Correction – to correct any mistake in posting. This can be used to add or deduct funds to adjust the balance
- Example: adding $50 adjusts the balance under Amount Owed
- Transfer Back – appears every time a balance is moved from one entity to another. This option is
used to return a balance back to where it came from
- Secondary Transfers – to move a balance from the primary to the secondary insurance
- Example – $100 is patient’s copayment, since patient has a secondary insurance, this will then be transferred to that insurance and not the patient by choosing Secondary Transfers
- Claim History – shows the history of adjustments and details of the check entered into the system for the payment
- Selecting the Edit Payment link pulls up the Payment Editing Tool
- If you need to adjust a payment, simply indicate the value to add or deduct to the payment amount
in the Adjustment Amount field- Example: the payment for 99214 should only be $75, but it was incorrectly entered at $100. Enter the amount to deduct in the Adjustment field and hit Submit
NOTES
Types of Patient Transfers:
- Balance Bill – used to bill the entire balance to the patient
- Coinsurance
- Copay
- Deductible
- Other (to bill a portion of the balance to the patient that doesn’t fall under balance bill,
coinsurance, copay, or deductible
Types of Voids: (will void the entire line item)
- Duplicate
- Global
- Void (deleted a claim created in error)
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