Description:
Issue 1: The claim details (i.e. TCN, Patient First and last name, CPT codes, modifiers, DOS) associated to the payment does not match the claim details associated to the current claim. This could be caused by:
The claim was not submitted through our application. Meaning it was sent by another vendor.
The details associated to the claim (i.e. TCN, Patient First and last name, CPT codes, modifiers, DOS) were modified after the claim was submitted.
Issue 2: The payment for one charge was separated into two payments by the payer.
How to Fix:
Solution 1: Select “Remove”. This action will remove payments/adjustments related to the charge that was not found.
Solution 2: Select “Find Charge” to locate the line item that has been split up. Select the CPT this payment/adjustment should be attached to. Then select “Save”.
Description: The patient’s record was open at the time the attempt to apply Electronic Remittance Advice.
How to Fix:
Solution 1 (Recommended): Close out the opened patient record. Select “Apply” to reattempt the posting of payment(s)/adjustment(s)
Solution 2: Select “Remove”. Note: The payment will still be remaining and should be manually posted via View screen under the Payment section.
Description: There was no previous existing adjustment found on the claim
How to Fix:
Solution 1: Select “Apply”.
Since no previous adjustment can be located to the claim the claim balance will increase. Please be sure to validate the balance and determine what new adjustment amount should be placed if applicable.
Solution 2 (Recommended): Remove. This action will ignore the reversal of adjustment.
Description: The patient or claim was not created within CollaborateMD or is inactive. This could be caused by:
Issue 1: The claim was not submitted from our application. Meaning it was sent by another vendor.
Issue 2: The patient/claim has been deleted from CollaborateMD.
How to Fix:
Solution 1: If the claim was submitted through another vendor, we recommend that you manually post the payment within their application by referencing the explanation of benefits we received from the ERA file which is located under the View EOB tab.
Solution 2: If the patient or claim was deleted from CollaborateMD, undelete the claim in Manage Account or reactivate the patient’s record within the Patient section. Once the claim or patient has been reactivated, manually post the payment to the applied check under the View screen under the Payment section.
Description: The balance of the charge has already been paid and the balance is set to $0.00.
How to Fix:
Solution 1: Select “Apply”.
If a payment was already applied to the claim, a credit will be placed on the patients account. Please be sure to refund any credits to the necessary parties, if applicable.
Solution 2 (Recommended): Remove . This action will remove payments/adjustments related to the charge that has a $0.00 balance.
Description:
Issue 1: A payment was already applied by the same payer.
Issue 2: The payer on the claim may have been changed from when the claim was originally submitted.
How to Fix:
Solution 1: To correct this issue review the claim activity to verify if the payment that was posted matches the new payment received.
Verify if the check number, check date and check amount are the same. If they are the same do not re-post the payment.
If the check details are different select the “Apply” option.
If a payment was already applied to the claim a credit will be placed on the patients account. Please be sure to refund any credits to the necessary parties, if applicable.
Solution 2: To correct this issue, update the claim/patient account with the appropriate payer. After the Payer has been updated, select the “Apply” option.
Description: This is typically correct as the adjustments may not have taken all prior payments and adjustments into account.
How to Fix:
Verify existing payment(s) and adjustments to this charge. If necessary select “Apply” to allow posting of the secondary adjustment.
A credit may be placed on the patients account if prior payment(s)/adjustment(s) were not validated. Please be sure to refund any credits to the necessary parties, if applicable.
Warning: The payer for this check could not be found in your payer list. The source of this payment has been set to the primary payer on the claim
Description: The CPID listed on the check sent back from the payer does not match the CPID listed on the claim.
How to Fix:
Solution 1: Choose to “Apply anyway”. This will result in the payment posting under the claim’s primary payer’s name.
Solution 2: Update the CPID listed on the claim. Then reattempt to auto-apply the payment.