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mdunham
Premolar III

Tracking Insurance Payments and Adjustments by CONTRACT ALLOWANCE TABLE

Problem:  Insurance Income and Adjustment Reports by company cannot be correct for providers in which are contracted with Third-party Payers.  This is due to the fact that TPP's change clients or provider is cross networked.  

Suggestion;   Create Insurance payment and Insurance Adjustment Modifier codes that describe a payment made by the TPP or Ins company.   Create a monthly report that includes these modifier codes. When this is done the practice is better informed in respect to income and adjustments generated by CONTRACT.    SD would need then to correct the Default adjustment and Payment codes to be flexible per practice to avoid posting errors via e-posting service, etc.  

  Example:  2.02 Metlife payment, 50.19 MetLife Adjustment.   2.03 Connection Plan Payment, 50.20- Connection Adjustment ,2.04 Careington Payment 50.30 Careington Adjustment. etc.