How do I Manually Enter an Insurance Claim Adjustment or Denial

• Purpose:
• Where do I enter a claim adjustment or denial?

Purpose:

Use when entering a claim adjustment or denial or when transferring to the next responsible insurance when no payment was received.

Where do I enter a claim adjustment or denial?

On the Account Dashboard ($), select Third Party Billing

Then select Process Existing Claims Tab>Deny Claim

Applying payment from selected insurance screen opens.

• The grid contains all open claims for selected insurance

• Search by name or patient ID. Note that when searching, all claims remain on the grid and the searched for claims move to the top of the screen.

• Select claim line and Deny claim

• Select TCN and Denial Reason Screen opens

Select TCN and Denial Reason Fields	Description
Adjudication Date	Date on remittance advice.
TCN	Click in TCN and enter TCN (insurance assigned claim number) and Tab to save.
Adjustments	Click in Adjustment field - see How do I manually enter an Insurance claim adjustment information?
Write Off	When selecting write off, invoice will be credited.
Resubmit	Invoice will be available on the Deny Resubmit Screen
Save, Leave-Open	TCN and adjustment information are saved, claim remains open. How do I Manually Enter an Insurance Claim Adjustment Group and Codes
Apply & Transfer	Credit adjustment is applied to invoice, an invoice is created for the next insurance. NOTE: This button is only available when the next responsible insurance coverage record has the check box selected Auto-transfer balance to this carrier.

How do I Manually Enter an Insurance Claim Adjustment Group and Codes – Netalytics (zendesk.com)