Path: Smart Toolbar > Billing button > Adjudications tab
Payers will, at times, reverse previous adjudications for numerous reasons (e.g. plan termed, duplicate charge, etc). ERA reversals received through an ERA adjudication will automatically process to a generic account setup for payments/retractions that OP cannot specifically trace to a specific patient account. The generic account is acct #-5, Provider Adj. E-Billing. OP will automatically create a claim which will appear on your current claims tab. OP will only make adjudications visible to the user if the corresponding charge transaction is archived (i.e. daysheeted). Since OP creates a current claim to post these reversal transactions against, you will first need to run a daysheet so that these adjudications will be visible for posting.
To determine the reversal details, you can either:
- Contact the payer directly.
- Check your clearinghouse for a copy of the corresponding EOB where this reversal was recorded.
- On the Adjudications tab of the e-Billing center, change the match status of the reversal adjudication (as assigned to an account by the name of Provider Adj. E-Billing) to Discard, approve and post the transaction.
Electronic Billing Center
- Go to the E-Billing Provider Adjustment Account and Click on the Claims tab.
- Locate and click on the claim with the referenced reversal so that it appears highlighted.
- Click on the Void minus button to delete this "claim".
- Click Yes when prompted "This action will delete the entire claim, Are you Sure?"