Billing Adjustments

Billing adjustments are used to reduce the balance of a Patient Billable. These adjustments are customizable and can be applied as a percentage or a dollar amount.  

Create Adjustment Reasons

Click below for instructions on creating a custom adjustment reason in the RCM!

Required Permissions: Only Managing Organization Admins and Organization Admins can customize adjustment reasons. For more information on user profiles, click here.

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  1. Navigate to the Organization Admin > Configuration > Adjustment Reasons.
  2. Select Create New Adjustment Reason.

  3. Enter a description of the adjustment.
     

     Then enter a Short Code that helps identify the reason for the adjustment.

  4. Finally, select Submit.
     

Recording Adjustments

A user can make adjustments to patient billables within the patient's profile using two methods. Let's examine each option to determine which workflow suits you best.

Required Permissions: User-level profiles will need permission to record adjustments. For more information on patient billing user permissions, click here.

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  1. Navigate to Patient > Patient Billing > Collect Payment.
     
  2. Click Record Adjustment.
     
  3. Select the billable you wish to adjust.
     
  4. Then select the Reason for the adjustment from the drop-down.
     
  5. The system defaults to using a dollar amount for the Adjustment Amount Type. This field can be updated to reduce the billable by percentage when applicable.
     

  6. For Dollar Amount, input the amount that should be deducted from the balance.

     • For Percentage, input the overall percentage you'd like to reduce the balance by.
        

     Add any pertinent notes when applicable and click Submit to complete the process.

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  1. Navigate to Patient > Patient Billing > Patient Billables.
     
  2. Locate the patient's billable and click Adjust.
     
  3. Select the Reason for the adjustment from the drop-down.
     
  4. The system defaults to using a dollar amount for the Adjustment Amount Type. This field can be updated to reduce the billable by percentage when applicable.
     

  5. For Dollar Amount, input the amount that should be deducted from the balance.

     • For Percentage, input the overall percentage you'd like to reduce the balance by.
        

     Add any pertinent notes when applicable and click Submit to complete the process.

Voiding Adjustments

Patient Billables that have their entire balance adjusted will close automatically. If an error is made and the billable needs to be reopened, an adjustment can be voided by navigating to Patient > Patient Billing > Payments. In this section, a user can select Void:

Then select Submit, reverse the adjustment made, and re-open the patient billable.

The voided adjustment will then show a negative amount and a voided action to indicate the process is complete.

PR-45 Adjustments

For organizations that do not collect patient responsibility on balances generated by PR-45 adjustments, a feature is available that automatically applies an adjustment to the billable upon approval.

For example, if a billable has a total of $250 in patient responsibility and $100 stems from a PR-45 adjustment, the system will automatically reduce the billable balance by $100 upon approval, leaving $150 to be collected from the patient.

To have this setting enabled, a Managing Organization Admin or Organization Admin can contact support at [e-mail] for assistance.