Working with automatic contracted write-off adjustments

With a certain Ledger rule turned on, write-off adjustments get posted automatically for procedures that are contracted with insurance plans. You can do the following with an automatic contracted write-off adjustment:

• If the patient does not have a secondary insurance plan, when the primary claim is created, you can see the adjustment in the Ledger and on reports immediately.

• When posting the insurance payment for that claim, you can see the adjustment and even edit it if necessary.

• You can delete and re-post an incorrect automatic adjustment without having to delete and re-create the associated claim.

Notes:

• If a patient has a secondary insurance plan with a contracted fee schedule, Dentrix Ascend will post an automatic write-off adjustment, if needed, for the secondary claim after you post an insurance payment for the primary insurance claim. The automatic posting of contracted write-off adjustments does not apply to tertiary insurance claims.

• Be aware that a write-off adjustment is not posted automatically for a primary insurance claim in any of the following situations:

  • The claim billing provider is not contracted with the insurance carrier.

  • For any procedure on the claim, the contracted amount from the secondary insurance carrier's fee schedule is equal to the contracted amount from the primary insurance carrier's fee schedule.

  • For any procedure on the claim, the sum of the estimated primary and secondary insurance payments is equal to the UCR fee.

 

Viewing the automatic adjustment immediately

If the patient does not have a secondary insurance plan, after you create a primary insurance claim, an insurance adjustment for the amount of the write-off appears in the following areas of Dentrix Ascend:

• In the patient's Ledger as an insurance adjustment.

  

• On the Patient Walkout as an insurance adjustment.

  

• On the Provider A/R Totals Report, under Production, in the Credit Adj column.

  

  Note: Because of the potential of actual write-off amounts being different than what is expected, the Provider A/R Totals Report is only an estimate until you enter the actual insurance payments for procedures within the date range of the report.

 

Viewing and editing the automatic adjustment when entering an insurance payment

When you are posting an insurance payment, the insurance adjustment that was posted automatically for the write-off appears.

Do any of the following:

• To delete the adjustment that was posted automatically, from the Insurance Adjustment list, select Offsetting (+).

  

• If the claim has multiple procedures, to change how the adjustment is allocated to the procedures on the claim, change the amounts in the Adjustment column as needed.

  

• To change the total amount of the adjustment, change the amounts in the Adjustment column.

  

  

  Notes:

  • If the adjustment is not locked, the adjustment amount will be updated on the ledger.

  • If the adjustment is locked, and the adjustment amount has been increased, another write-off will be posted automatically to correct the balance.

  • If the adjustment is locked, and the adjustment amount has been decreased, an offsetting charge adjustment will be posted automatically to correct the balance. A message will appear and ask you to confirm that you want the offsetting adjustment to be posted. To confirm the action, click (or tap) Save.

 

Deleting the automatic adjustment and posting an insurance payment without the write-off

If a write-off is not applicable for procedures billed to insurance, you can delete the automatic adjustment and then post an insurance payment with an offsetting adjustment. Do the following:

1. Delete the automatic insurance adjustment on the patient's ledger.

   Note: If an insurance payment is associated with the claim, delete the payment, which also deletes the adjustment. Then, you can post a new insurance payment.

2. Post an insurance payment. As you are setting up the payment details, from the Insurance Adjustment list, select Offsetting (+).

   

3. Click (or tap) Save.

   The insurance payment appears on patient's ledger, but the write-off does not.

   

 

Deleting the automatic adjustment and automatically re-posting it for the correct amount

If the amount of the automatic adjustment is incorrect because, for example, the insurance plan information is out of date, you can delete and re-post the adjustment without deleting and re-creating the claim as long as an insurance payment is not associated with the claim. Do the following:

1. Delete the automatic insurance adjustment on the patient's ledger.

   Note: If an insurance payment is associated with the claim, delete the payment, which also deletes the adjustment. But, you will have to re-enter the payment after completing the following steps.

2. Update the insurance plan's fee schedule with the correct allowed amounts for the procedures on the claim.

3. Open the claim from the patient ledger, set the Create contracted write-off when claim is saved switch to Yes, and then click (or tap) Save.