Working with Reversals and Adjustments







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After batches have been posted, invoices can no longer be edited.  Sometimes, however, there will be a need to reverse or adjust a payment once it has been posted.  This can be done directly in AWARDS by looking up the TCN Claim Control Number and invoice information, adding the reversed or adjusted invoices to a new or existing batch, and then creating another claim file.

To submit a reversal or adjustment, complete the following steps:

    1. From the AWARDS Home screen, click Administration from the left-hand menu, and then click Fiscal.  The Fiscal fly-out menu is displayed.
    2. Click BillingBuilderThe BillingBuilder Menu page is displayed. 

    1. Click Remittances/Responses. The Billing Remittance Processing page is displayed.

    1. Click Remittance/Response Files.  The Remittance/Response Information page is displayed.
    2. Click Read Remittance/Response File.  The Read Remittance/Response Information page is displayed
    3. In the Select the File to Read table, click the radio button next to the file containing the invoice to be reversed or adjusted.
    4. Click CONTINUE.  The Remittance/Response Information page is displayed.  This page contains a table of invoice information, including the invoice number and TCN Claim Control Number.
    5. Locate the invoice to be reversed or adjusted on the table, and note the Invoice and TCN Claim Control #, as you will need to enter these in later steps.

    1. From the bottom of this page, click Billing Menu.  The Billing Menu page is displayed.
    2. Click Edit Invoice Batch.  The Edit Billings page is displayed.
    3. Click Show Posted Batches so that the corresponding drop-down list expands to include posted batches.
    4. Click the Batch Number drop-down arrow and select the batch that contains the original invoice.
    5. Click View.  The details of the batch are displayed in a read-only table.
    6. Locate the specific invoice to be reversed or adjusted, and note the Diagnosis, Service Date, Procedure Code, NPI, Service Units, and Amount, as you will need to use this information in later steps.
    7. From the bottom of this page, click Billing Menu.  The Billing Menu page is displayed.
    8. Click Edit Invoice Batch.  The Edit Billings page is displayed.
    9. Click the Batch Number drop-down arrow and select any invoice batch that is ready to be submitted.  This is the batch in which the reversed or adjusted invoices will be added.

  TIP: Alternatively, you can also create a new, empty batch in which to add the reversed or adjusted invoices.  To use this method, first create an empty batch using the procedure outlined under Generating Invoices. Select "Generate Empty Batch" from the Billing Action drop-down list in step 7 of the procedure.  Once the empty batch is created, select that batch to use in this step, and proceed with step 18

    1. Click Update.  The details of the batch are displayed in a data entry table.
    2. Click Add Invoice.  The Add Invoice page is displayed.
    3. Click the Program drop-down arrow and select the program associated with the consumer for whom the reversal or adjustment is being made.
    4. If the reversal or adjustment is for a former (discharged) consumer, click the Roster Archives checkbox.
    5. Click CONTINUE.  The Add Invoice page is displayed.
    6. Click the Consumer drop-down arrow and select the consumer for whom the reversal or adjustment is being made.
    7. Click CONTINUE.  The Edit Billings - Add Invoice Number page is displayed, containing a data entry table.

    1. Complete the fields and options on this page as appropriate, using the data collected in previous steps.  All fields are required:  Diagnosis, Service Date, Procedure, NPI, Svc Units, Amount, Void/Adjust (drop-down list containing "Void" and "Adjustment"), and TCN Claim Control #.

  TIP: If a reversal (or "void") is being processed, the Amount entered should be the same amount that was on the original invoice.  If an adjustment is being processed, the Amount entered should be the new amount to appear on the invoice.

    1. Once all of the necessary information has been entered, click ADD THIS INVOICE.  The details of the batch are displayed once again in a data entry table, with the newly added invoice included.
    2. Click Save to save the invoice to the batch and return to the Edit Billings page.
    3. Click Add Invoice to continue adding invoices for additional reversals or adjustments, repeating steps 20-27 as necessary.
    4. Once all invoice batches have been edited as necessary, create an insurance claim file and submit the file to your payer as described in Creating Insurance Claims.  The new claim file will contain the information for the reversal and adjustments.

The process of working with reversals and adjustments is now complete.

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