This most often occurs when the Patient has a private insurance versus a group insurance for the secondary.
- The Secondary Payment is more than the balance.
- Posting the Secondary Payment will leave a credit.
Scenarios
If the Secondary Payer paid as Primary in error, the over payment should be refunded.
If the Secondary Payer has verified that this Payment is correct because of a higher allowed amount, you can reverse a Primary adjustment, and post the Secondary Payment.
Reverse the Primary Adjustment/Post Secondary Payment
Reverse the Primary Adjustment for the same amount as the credit would be if the the Secondary Payment was posted.
- The object is to have a balance of zero when finished.
Example:
- Primary Payment: $150
- Primary Allowed: $175
- Primary CO45 Adjustment: $75
- Primary PR: $25
- Balance is $25
- Secondary Payment: $50 (There is a balance of $25)
- Secondary Allowed: $200 ($25 more than the Primary Allowed)
- Balance would be -$25 if posted.
Reverse the Adjustment and Post the Payment
Use Post Expert:
- If the Patient ID is populated, tab.
- If blank, find the Patient or enter the Encounter number preceded by an e (e1234).
- Select the line item where the adjustment needs to be reversed.
- Enter Transaction Code: IP
- Enter another Transaction Code: CO45.
- Amount: -25.00 (negative) (Enter the amount that shows as the balance at the top of the Posting screen.)
- Tab (Balance should be $0.00)
- Select Save [F2].