Note: If you are setup to pull in ERA's from the clearinghouse then the Adjustments will be applied to the client's invoice when you apply the payment. If you are not setup to pull in ERA's, you can activate this feature on the clearinghouse's side by contacting them or enter adjustments manually following this article.
How do I pull in ERA's from the clearinghouse and apply to invoices?
If you are not setup to pull in ERA's from the clearinghouse you can apply an adjustment to a client's invoice manually from the client's ledger.
Please note: currently adjustments do not affect the balance on the invoice.
1. Open the invoice by clicking Select an Action > Details.
2. Click + Adjustment at the top of the invoice.
3. Select the Type of Adjustment that you would like to apply to the invoice (Other, Deductible, Coinsurance, Copayment, Amount Exceeds Contracted Rate).
4. After you have selected the Adjustment type, you can enter the amount, adjudication/payment date, select which service to apply it to and mark whether it was paid or not.
Please note: When you submit an electronic claim to secondary you'll want to use the adjustments on the invoice so secondary knows which portions were not paid. The adjustment amounts identified as not paid is everything that the primary insurance did not cover.
Adjustment + Invoice Payments = Original Balance of Invoice
Adjustment = Unpaid amount
The Adjudication (Payment) Date = The date the claim was paid by primary ~ the ERA/EOB date or date on the check (if paid by paper check)
5. The Adjustment will show at the bottom of the invoice and will be pulled in when you submit the claim to the Secondary Insurance provider.
How do I submit a claim to the secondary insurance provider?