This document will review the process of posting a Payment (EOB/ERA) Level Adjustment. These adjustments appear on the first page of an EOB/ERA and either increase or decrease the applied/unapplied amount. These should be posted as they appear on the EOB/ERA to confirm proper balancing of the check.
Note: It is important to confirm these are posted before applying to claims or the check will not balance and will have to be voided and the user will have to start all over again.
This document implies the “Posting an Insurance Payment – Manually” training document has been reviewed.
Step 1-Enter Amount
Enter the dollar amount as indicated by the EOB/ERA. It is important to post the positive and negative values correctly as indicated by the EOB/ERA.
Positive Payment Level Adjustment – Increases the unapplied amount, giving more money to balance the claims then what was actually paid on the check.
Example: Overpayment recovery
Negative Payment Level Adjustments – Decreases the unapplied, allowing for balancing of the check when payment was received that was not directly related to the balancing of a claim.
Step 2-Select Adjustment Reason
Health-Fusion offers a pre-established list of all known reasons that will appear in the drop down box.
Step 3-Enter Note
This step is optional.
Notes can be entered to track information about the patient encounter, conversations or follow ups with the payer about this payment/patient, or to make note of which user is posting the information.
Step 4-Click "Add Adjustment"
To apply the adjustment; click “Add Adjustment” at the bottom.
Note: It is important to confirm these are posted before applying to claims or the check will not balance and will have to be voided and the user will have to start all over again.