A/R SUPPORT TABLES

 

A/R Adjustment Reason Type  - Use to provides descriptions for common reasons for making A/R adjustments  i.e., contractual adjustments, PPS type adjustments, sales adjustments etc

Agency Payment Type - Use to select the reason for applying cash/payments to an agency account  when you can’t yet apply the payment to a specific patient invoice.

ERA Reason Type - ERA Reason code appears on your remittance advice and corresponds to the reason for a sequestration reduction.  For sequestration reductions that appear on the ERA claim, the adjustment can be done at the line item detail, invoice level or both depending on the type of sequestration reduction.

Incremental Billing Code - Specific codes established for additional billing situations such as billing every 15 minutes after you bill the first hour and 15 minutes, rounding up units when there are more than 15 minutes, billing units are capped at 4 regardless of actual units created, etc. There are 4 standard codes for special billing situations.  The codes in this table are attached to Organization Payer Service Codes for any service that requires special billing calculations.  Contact Careficient support team if additional codes are needed.  

Invoice Note Type - Displays the various reasons for generating an automated invoice note. Notes will be automatically created when the RAP is billed, the invoice is denied or when partial payments exist.

Payment Sources - Payment source is selected pas part of adding payments to the A/R module.  Use Add link to add a new payment source if the payment source doesn’t display in the table as well as the method of payment i.e., check, cash EDI,  credit card etc.

HCPC Modifier Type - HCPC (Healthcare Common Procedure Coding) modifiers are standard healthcare industry codes that further define services being billed to a specific payment source such as RN Services and specific procedures provided.  Example:  RN Routine Service has a standard HCPC code of G0299.  You provide dressing change for one wound which is modifier code A1.  The RN sService you bill will be G0299, A1.  If you are proving dressing changes for three wounds the modifier would be A3.  The RN service you bill for will be G0299, A3.  Your payer will let you know what HCPC codes and modifiers you need for billing.  Keep in mind that while these are standard healthcare industry codes, some codes are reserved for state and waiver as well as other payers to specifically define.  If you do not see a code in the table that you need to use, you can add the code/description to this table.  You can use these codes when you add/update Service Codes for your agency as well as specific Service Codes you add to your Organization payer.