Kevin Take a look at the PLB segment in the 835. Jan
Kevin McAcy wrote: > I have a question concerning the reporting of claim adjustments on the 835 > transaction: I represent a health insurer and sometimes, a correction to a > claim that has already been paid is submitted by the provider and results in > an amount owed back to us. We currently do not have an automatic offsetting > process in place. Instead, the reimbursement request is handled manually by a > Refunds department, and the payment, when and if it is received, may be spread > out over time in installments. Also, business decisions or contract > provisions may cause us to discontinue the transaction, writing off the > amount. > > Is anyone aware of a method to report these treatments on the 835 transaction? > That is, is there a procedure or transaction code that would enable us to > acknowledge an amount to be written off or that is pending payment? The 835 > will not allow us to display a negative total payment amount (BPR02) for a > provider. > > I would appreciate any thoughts or leads. > > Thank you > > Kevin McAcy > Systems Analyst > Blue Cross Blue Shield of Nebraska > x. 3535 > Email: [EMAIL PROTECTED]
