#15 – Enters Adjustment Transactions w/ Detailed Accuracy.

The goal for adjustment entries (ledgers, transactions, enter adjustment) is to be clear at any time in the future, to anyone who checks the detail to see totally clear explanation of why the adjustment was given.  There are close to 40 adjustments listed, about half are credit adjustments (decrease the patient’s account balance), and the other half debit adjustments (increase the patient’s account balance).   Following are the credit adjustments that you will be entering.

  • Courtesy Adjustment: used mainly for adjusting off the balance for a charge such as emergency exams, or if the dr wants to give a 10% adjustment for a special reason.  GUIDE: enter amount on the patient who had the service (not the guarantor), enter for the provider who did the work. In the NOTE section: enter a simple explanation such as: “No charge for emer exam,” and then enter your initials. Also you will specifically need to change the provider to select the correct one. If you don’t it will default to the provider who is listed in the family file.  (For example: If EFD1 did the emergency exam, then EFD1 gets the adjustment). This prevents a debit/credit situation on the patient’s account, which causes extra work for the accounting staff after the month is closed. Then more adjustments need to be entered to fix the error made when the original adjustment was entered.
  • Cash Discount: this is used to reflect the discount for paying cash. GUIDE: enter amount on the guarantor and not the specific patient. Enter for the provider who did the work.  In the NOTE section: enter the details for the amount of the transaction, “5% of patient’s share of 350.00” so that it can easily be verified that you have entered the correct amount.  Always enter your initials at the end of the note.
  • Senior Citizen Discount: this is used to reflect the 10% Senior Citizen Discount for patients aged 60 or older. GUIDE : enter amount on the patient who had the service (not the guarantor), enter for the provider who did the work. In the NOTE section: enter the details for the amount of the transaction, “10% of total charge of 180.00” so that it can easily be verified that you have entered the correct amount. Always enter your initials at the end of the note.  Tip: for a prophy appt, where you have the hygienist who does the prophy (62.00) and the dr who does the exam (32.00), you will only enter one adjustment of 9.40 which is 10% of the total charge. You can enter this on either provider. Just make sure that the adjustment will not create a debit/credit situation on the account – where one provider has a negative amount and another provider has a positive amount.
  • New Patient Credit: this is used to reflect the $86 care to share credit. GUIDE : enter amount on the patient who had the service (not the guarantor), enter for the provider who did the work. In the NOTE section: enter “NP credit” and then enter your initials.
  • Charge Reversed: this can be used for several reasons (some listed below).
    1. An error was made in a previous charge (and the month has already been closed). A charge may have been entered for a service that was not actually done on the patient. It may have been entered on the wrong patient, or the patient cancelled and their appt was set complete anyway.  For whatever the reason, it needs to be corrected. GUIDE : enter amount on the patient who had the incorrect charge (not the guarantor), enter for the provider who was entered as having done the work. In the NOTE section you will need to provide the exact detail of why you are reversing this charge:  such as “Charge on 8/15/05 –[always enter the previous date] for PVC #14 [always enter what the previous tx was] entered in error.  Patient did not have this work done or [tx was posted to the wrong account].” Then enter your initials.
    2. The patient may have had some type of tx that did not solve their problem and they will need to have a different type of tx. (They may have had a RC, but they are still having pain, and may need to be referred to an endodontist to redo the work, or they may be referred to an oral surgeon to have the tooth extracted). GUIDE : enter amount on the patient who had the previous service (not the guarantor), enter for the provider who initially performed the tx.  In the NOTE section you will need to provide the exact detail of why you are reversing this charge: such as “RC on 8/15/05 –[always enter the previous date] needs to be redone. Pt referred to Dr Clark” Then enter your initials.
  • Warranty Credit: all treatment done at HealthPark is warrantied for 3 years from the date of service if the patient has returned for continuing care appointments at the recommended intervals. The dentist has the final say in whether or not he/she wants to allow the warranty if the patient has not met this requirement.  Here is the info that needs to be included in the NOTE for the description when you enter the warranty adjustment:
    1. The tooth (or teeth) number(s) under warranty and treatment done.
    2. The date of the original treatment.
    3. The provider who did the original tx.
    4. Your initials

Example of NOTE: “ 2surf comp #8 originally done by Dr Smith on 8/17/04”  LHS

Other things to remember:

The warranty credit adjustment is always applied to the provider who did the re-do of the treatment.  An exception is for providers no longer working at __________; this adjustment is then taken off ________.

  1. It is ideal to have the original treating provider do the warranty work.
  2. If there has been a price increase since the patient had the original treatment, the patient will receive the warranty credit adjustment for the current charge of the treatment.
  3. Warranty work is not sent to insurance.

 

____________________________________                                    _________________

                                    Team Leader                                                                                     Date