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Premolar I

Distributing to an adjustment code that increases the balance.

Question....we have some adjustment codes that increase the balance and have always been able to distribute payments to them.  Recently, I am not able to distribute to those codes.  Did something change?

Here is an example of when we use these codes:

We had a patient that BCBS decided to do an audit on the claim payments they sent us over the past several years.  BCBS requested a refund for an old claim they paid.  We refunded the payment to BCBS creating a balance on the patient's ledger.  We decided since the claim was old to writeoff the balance using a discount code that is set up as an "adj (production) that decreases the balance.  I am not able to distribute the discounted amount to the refund.

Another example:

When a patient has a balance that is over 90 days, we send them a letter and we use an adjustment code "uncollec" to bring the balance on the ledger to zero so that we are not prompted to send statements.  When the patient comes in for their next appointment (usually their next recall) we put the amount back on the patients ledger using the adjustment code "debt".  When the patient pays their balance, we are not able to distribute it to the debt code.  The 'uncollec" code is set up as an "adj (collection)' code that decreases the balance.  The "debt" code is set up as an "adj (collection)" code that increases the balance.

We have been using these codes for years without any issues until recently.  If something has changed, please let me know how to accomplish the same results in the above issues with the new rules of distributing. 


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