Reverse an Encounter for Modification or Deletion

Reverse an Encounter for Modification or Deletion

Reverse an Encounter to Delete or Modify

Reversal Methods

  • Reverse for Deletion reverses the Encounter by creating an equal but opposite Encounter that is not editable and is reported in the current accounting period. This action cannot be undone.

  • Reverse for Modification retains the original Encounter that is editable and is in the current accounting period.

    • Two Encounters will be created with opposing Procedure Fees.

      • This is a reversal of the original encounter and fees.

    • A new Encounter screen will be created as a clone of the original Encounter

      • The new Encounter has the same Encounter number as the original Encounter and contains all of the original charges.

      • This new Encounter screen can be modified.

    • The Post Date and Reference Batch will be updated for the Encounter.

    • The Reversal cannot be "Un-reversed (undone).

Patient Dashboard view after the Reversal is done



Connect to a Reference Batch before attempting to Reverse an Encounter.

Reverse for Modification

  1. From the Actions panel on the Encounter Dashboard, click Reverse.

  2. Method: Choose Reverse for Modification.

  3. Enter a Reason For Reversal.

  4. I understand: After reading each one, select all the boxes. Once saved the Reversal cannot be undone.

  5. Reversal Options:

    • Rebill Primary: If the Rebill option is selected, the primary insurance on the Encounter will automatically be set to a "Ready for Resubmission" Status when Reversed for Modification. If this option is not selected, all insurance on the Encounter will retain their current Claim Status.

    • Undo Transactions: If the checkbox is not selected, the Payments that were on the original Encounter will auto-post on the new Encounter. Select the Undo Transactions option if you want all payments and adjustments that were posted on the original Encounter to be removed (undone) and placed in Escrow. The Payments that were moved into Escrow and must be reposted.

  1. Click Save (F2). This button is gray if you have not checked all the boxes.

    • If the Encounter is in Payer Accepted or Clearinghouse Accepted status, you will get a Validation Warning:

      • Validation Warning: The Claim has been Payer Accepted or Clearinghouse Accepted. Any changes made to the Encounter may not match the ERA and may need to be posted manually. Are you sure you want to Reverse for Modification?

      • Click Save and Continue.

      • The new Encounter screen will display and can be modified.



  1. An identical Encounter will be created where you can make modifications. On the Encounter screen that displays, click Modify to make the necessary changes on the claim.


Original Encounter that was reversed.

Reverse for Deletion 

  1. Under the Actions panel on the Encounter Dashboard, click Reverse.

  2. Choose Reverse for Deletion.

  3. Enter Reason for Reversal.

  4. I Understand: Check the boxes. This action cannot be undone after saving

  5. Transactions that will be Undone.

    • It is best to repost all receipts before Reversing the Encounter for Deletion.

    • If the receipts are not reposted, the amount will remain in Escrow until posted to another Encounter or Disbursed.

  1. Click Save (F2).

 

An Appointment is linked to the Reversed Encounter

  1. Reversed for Modification: The Appointment is linked automatically to the new Encounter.
  2. Reversed for Deletion: The Appointment is disconnected and is eligible to be linked on another Encounter.

Line Item Reversed for Deletion containing a Posted Payment

If a Line Item is Reversed with a posted Payment, the money goes to Escrow and will remain in Escrow until it is reposted. Since money should never be left in Escrow, this Payment needs to be posted.

Example:

  1. A claim was billed and an Insurance Payment was posted to this Encounter for Line Item 1.
  2. Afterwards, you discover that the CPT on Line Item 1 is incorrect.
  3. You delete the incorrect CPT from the Encounter and add a new one.
  4. The money that was posted to the original CPT lands in Escrow and needs to be reposted while waiting for the Payer to do a takeback.
  5. The Transaction is now in a closed Period.

Repost the Money in Escrow

  1. Attach to a current Reference Batch or open a new Reference Batch.
  2. From the Encounter Dashboard, go to the Receipt that contains the Escrow.
  3. Select the Post (Expert Mode) button.
  4. If the Patient ID is already there, Tab, If not, do a lookup.
  5. Select the Encounter where the Line Item was deleted.
  6. Repost the original Payment and Adjustments to the replacement CPT or another Line Item.
    1. Use the original Transaction Codes, such as IP, CO45, PR2.
  7. Select Save [F2].




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