We changed how insurance payments are automatically recorded from our integrated clearinghouse, Claim.MD to conform with industry best practices.
Those of you who are entering insurance payments manually from a ERA must enter payments slightly differently to prevent patient adjustments from being created.
Here is what you need to do going forward.
If the patient’s invoice has a patient charge line (like a copay), manually record the information from the ERA by doing the following:
Enter the information from the ERA in each applicable box. For example, enter the Payment Amount, if the ERA shows a patient responsibility be sure to enter it into one of the highlighted boxes shown below.
For example if the ERA shows a patient responsibility of $20 for a copay, enter that amount in the Copay Adj. $ box even though there may be a patient charge for a copay on the invoice. This will not duplicate the patient charge. If you leave the Copay Adj. $ blank the patient charge on the invoice will change to a patient adjustment. Leaving the box blank tells TherapyMate that no copay is required so our system will change the patient charge line the invoice to a patient adjustment.
For example if the ERA shows a patient responsibility of $20 for a copay, enter that amount in the Copay Adj. $ box even though there may be a patient charge for a copay on the invoice. This will not duplicate the patient charge. If you leave the Copay Adj. $ blank the patient charge on the invoice will change to a patient adjustment. Leaving the box blank tells TherapyMate that no copay is required so our system will change the patient charge line the invoice to a patient adjustment.
If the patient's invoice didn't have a $20 patient charge line, the system will add one for you.
Here is a test example where the ERA shows an insurance payment of $45.40, along with a copay and co-insurance requirement.
Enter this information as shown below:
If you slightly alter how you enter ERA information you should be able to avoid patient adjustments.
If you slightly alter how you enter ERA information you should be able to avoid patient adjustments.
Reach out to Support if you have any questions.