Witholds and secondary claims

[hrw911]

I am referring to sending the claim to the secondary carrier after the primary carrier pays. The withhold amounts on the primary carrier determination do not get sent to the secondary carrier.

[Gavin Walker]

Because if you use the Withhold adjustment, you are saying the primary insurance is withholding that amount and they will pay you for it later. This happens with certain specialties where they may pay your for certain supplies, etc at the end of the year. If the amount should be written off, then you should use a regular Insurance adjustment.

[dkennelly]

So the code I have set up is MIPS-insurance withhold adjustment. This way, when I am on the Apply Payments/Adjustments Window applying my payments, I can enter the amount when putting in the payment and regular insurance adjustment. If I change it to Insurance Adjustment, it is not an option to enter it into the withhold column, and I would have to do it separately under adjustment and then go back in to that patient and apply the regular insurance adjustment. Is there another way to do it, so that it shows as an insurance adjustment and I can put it into a column in the payments/adjustments window so that I can apply all payments and adjustments in one step?

[Gavin Walker]

That is not what the withhold column is for. It becoming common now to have 2 insurance adjustments. If you want to track these, then setup a MIPS insurance adjustment and then run Practice Analysis to get a breakdown of the adjustments.

[dkennelly]

I've done that, but the apply payments window only allows for one insurance adjustment. How do I get it so I can apply it in the window the same time as the contractual adjustment?

[Gavin Walker]

I see. The auto-posting with Revenue Management can handle this, but the deposit entry window cannot. Let me see if eMDs would be willing to enhance this.