Charge correction

There are multiple occasions why a charge may be modified once it has been submitted from the EHR to the Practice Management system. Below is a list of what kinds of charge corrections occur and what in turn happens in the system.

1. Provider adds ICD9 – system creates an Adjust Charges task (delegated); comments are “one or more charges for this encounter need to be adjusted in the billing system”; changes can be identified in the Encounter Audit Log.

2. Provider removes ICD9 – system creates an Adjust Charges task; comments are “one or more charges for this encounter need to be adjusted in the billing system”; however when you open the encounter the ICD9 that was removed is crossed out with a status of “removed”.

3. Provider replaces ICD9 – system creates an Adjust Charges task; comments are “one or more charges for this encounter need to be adjusted in the billing system”; however when you open the encounter the ICD9 that was removed is crossed out and you cannot tell that a code was added unless you look at the Encounter Audit Log.

4. Provider adds Modifier - system creates an Adjust Charges task; comments are “one or more charges for this encounter need to be adjusted in the billing system”; changes can be identified in the Encounter Audit Log.

5. Provider adds CPT – newly added CPT either submits or goes to Review status and creates a new Review Enc Form task; once reviewer opens the encounter summary they can see that one task has the status of “submitted” and one has the status of “review”.

6. Provider removes CPT -system creates an Adjust Charges task; comments are “one or more charges for this encounter need to be adjusted in the billing system”; however when you open the encounter the CPT that was removed is crossed out with a status of “removed”.

7. Provider replaces CPT - system creates an Adjust Charges task; comments are “one or more charges for this encounter need to be adjusted in the billing system”; however when you open the encounter the CPT that was removed is crossed out has a status of “removed” and the newly added CPT has a status of either “submitted” or “review”.

8. Provider corrects encounter – a provider would need to remove the charges & diagnosis from the original encounter and submit a n/c code to clear the encounter, then create a new one with the correct encounter selected.

9. Correction of location, division or area – system creates an Adjust Charges task; comments are “one or more charges for this encounter need to be adjusted in the billing system”; changes can be identified in the Encounter Audit Log.

10. Incorrect Provider billed - system creates an Adjust Charges task; comments are “one or more charges for this encounter need to be adjusted in the billing system”; changes can be identified in the Encounter Audit Log.