130
FB Adjustment posting process
You will first receive an EOB with 1 negative FB adjustment. (This is the payor letting you know they WILL be taking these funds back but have not yet)
We recommend you manually post all these transactions to appropriately represent the future recoupment and balance the claims to the correct balance on the payer.
**If you do not already have an adjustment reason code ‘FB Adjustment’ as an option to select, you will want to add this under Adminà Listà List item entryà Adjustment reason codes before you start any manual postings for these claims.**
Now you will want to save the EOB that is linked to the AP payment to add manually to the claims you will add these negative adjustments to.
After this $0 payment is added, you will go to ‘Open payments’ and check the box ‘Show $0 payments’ so you can find this payment to post with.
Now with the EOB you will search for the claim or claims you will need to add these negative adjustments to using this new open payment we have posted.
Pulling up the first claim then post. You will want the payment field to be $0.
Then put in the negative adjustment amount that reflects on the EOB.
Make sure your ‘Adj Code’, ‘Payment code’, ‘Pmt/Adj from’, and transaction notes are matching correctly.
Lastly ‘Apply Changes’ and ‘Save’. Example below of how this should look like. You will repeat this process for each claim listed on the EOB matching the negative adjustment amount for each claim.
You can now mark this on the AP screen as handled so it cleans up your ‘New’ status payments to post.
Posting a negative adjustment will show the correct balance on the Payor and will show the claim in AR report allowing billers to work on the claim for AR recoupment.
Typically, after a week sometimes longer, you will have another FB EOB from the payor that will include the positive adjustment for the same amount we negatively applied with the example above. (This EOB is now showing you with the positive adjustment that they are taking these funds now). Also note that Payor is able to recoup partial amount (amount equivalent to the processed claim payment in this ERA).
This is how you will post this EOB.
From the AP screen you will want to select and post this to the claim showing paid for on this EOB. This should clear out any payor balance reflecting and move over any patient balance to the correct column.
**You may want to save this EOB from this AP to also attach to the other claims they are recouping from**
Then you will go to ‘Open payments’ and check the box ‘Show $0 payments’ so you can find this payment to post with again.
You will then search for the claims again from the previous EOB; these negative adjustments were posted too.
You’ll notice the amount to post is less than the amount we deducted. This is due to the payor relocating some of what was a FB to a newer claim paid. The remaining amount you will post to these other claims listed on the previous EOB. You should be able to use the Adjustment ID listed on the positive adjustment line item of this new EOB as a reference # if you need to locate the prior EOB to see which claims to post this to.
For this example, we only needed to post this payment and adjustments to 2 of these claims to balance out the open payment left over.
- You will add a positive payment for the amount they recouped. And a negative adjustment with the same amount. Also making sure you select the correct ‘Adj Code’, ‘Payment Code’, ‘Pmt/Adj From’, And add transaction notes. Then you will ‘Apply Changes’ and ‘Save’.
- You will repeat this step again to the next claim. The leftover amount of the payment you will post as is and again add a negative adjustment to match what the amount the payment was for.
Now this EOB is posted completely. You will now be able to see for all the claims they recouped from will reflect a payor balance of the amount recouped and then the claim they moved the funds to is balanced out. You will want to double check all EOBS are linked to the claims to show the documentation to why these postings were done.
