I recently noticed that one of our providers was receiving adjustments on our MCR payments for the e-RX penalty. Apparently our poster did not notice these since the amounts were automatically calculated in with the CO adjustments on the claims. Almost as soon as I realized they were penalizing us, we started receiving adjustments reversing the CO-237. Initially my thinking was that we needed to post the CO-237 as a separate adjustment from the regular CO-45, however when you do this and the claim is adjusted you are left with claims that have a balance of around $0.26 due from your secondary payer.
Am I wrong in thinking that we need to show these adjustments separately on the claim? I have discussed this with our administrator who feels like these should be automatic small balance adjustments. Is this ok to automatically write off this money? I know it would be much easier but I just want to make sure we are doing the right thing. If anyone has any advice at all on this issue, I would greatly appreciate it. Also I realized that the same situation is happening with the CO-223 for the sequester cuts. This adjustment is being added in with the CO-45. Should we not post this adjustment separately?
Thanks for any help at all!!
Am I wrong in thinking that we need to show these adjustments separately on the claim? I have discussed this with our administrator who feels like these should be automatic small balance adjustments. Is this ok to automatically write off this money? I know it would be much easier but I just want to make sure we are doing the right thing. If anyone has any advice at all on this issue, I would greatly appreciate it. Also I realized that the same situation is happening with the CO-223 for the sequester cuts. This adjustment is being added in with the CO-45. Should we not post this adjustment separately?
Thanks for any help at all!!