High credit discrepency in guarantor account

Red Flag: The account shows an abnormally high credit, potentially posted as a duplicate or additional "Not Allowed" amounts were added unnecessarily.

The Payments posted above as "PMT INSURANCE" were posted correctly but an additional "ADJ CONTRACTUAL" rate was added to poth payments to adjust the non paid or "allowed" amount.

How to correct the posting the error:

• Locate both insurance EOB's and review them carefully adding up the total on both claims to get the accurate total paid amount.
• Adjust the "ADJ CONTRACTUAL" rates around the total paid amount, they may not match the EOB precisely. Start by right clicking both adjusted contractual rate line items and select the "UNDISTRIBUTE' option on the drop down.

To undistribute the balance make sure to click the box next to the code on the popup box and select Accept.

• Do this for all asjusted rate lines on the single CPT code. It should look like the image below.

In the above scenario the combined value of both payments exceeded the billed amount and will remain with a negative balance of -13.09. If there was a positive value, you would then write it off with code 45 as the Adjusted contractual rate.

The image above shows a positive value without any adjusted rates,

To write it off simply right click the positive value after all payments have been added and the following window below will populate. be sure to write off the correct value and enter code 45 under "REASON"

Remember to void all extra Adjusted contractual rates from the undistributed credits tab that no longer apply. Simply select the line below>(Shift and the down arrow, or select them one by one) > right click>void/reverse.