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Service Correction Options

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This article outlines various options for correcting services. After reviewing the examples below, each organization should choose the best option for their workflow.

► Edit Services

Using the Edit Service Information form is the easiest way to edit certain service information.

When can I edit a service?

You can only edit services that have not been claimed or have been closed in an OPEN accounting period. Once a service has been claimed or closed in a CLOSED Accounting Period, then the services should not be edited. If you open a closed service in a CLOSED Accounting Period, it can lead to a number of issues and is not reccommended.

If you use Document Routing, and the service is associated with a note with a TIFF image, do not use the Edit Service Information form. The TIFF image can be updated with the information changed on this form, but the change will be recorded by the billing staff user who made the change, which is not an accepted practice at most organizations.

► Delete Services

When should I delete a service?

Sometimes, in order to correct service information, you may need to delete a service or claim. It is very important that you only delete services or claims if you are trained in recommended practices and understand the implications of deleting services. Deleting services and claims inadvertently can lead to unwanted consequences requiring data cleanup.

As always, please take care to ensure data integrity.

What do I need to know before deleting services?

Services that have any transactions posted against them can not have a Charge Reversal posted from the Delete Service form. This includes transactions that are the result of contract guarantor setup that automatically writes off the contractual allowance after the service has been closed. In these cases, you will need to do the charge reversal manually through one of the remittance posting forms for each line of liability distribution. If the charge with the automatic contractual allowance is still open (meaning the contractual adjustment is "temporary") and it does not have another transaction posted against it, you will post the Charge Reversal against the service using the Delete Service form. be sure to select to post the charge reversal.

Before posting a Charge Reversal:

  • Look at the client ledger for the service.
    If there are any transfers, payments, or adjustments to the service, they must all be reversed first for each line of liability distribution, essentially bring the entire charge back to the original amount.
  • Check that payments actually collected have been transferred to a deposit service or another service with outstanding liability, if needed.
  • Do not use the Delete Service (Opens Service Only) UNLESS an OPEN service was entered in error. 
    Note: Services with a transaction posted (transfers, payments or adjustments) will not show up in the form.
  • If the charge has been closed/claimed OR if the charge has any transfers/adjustments/payments posted, then it MUST have a charge reversal. If the charge reversal is not posted, this will cause an out of balance situation during monthly closeout.
  • The Delete Service form in conjunction with selecting Yes to the question Would you like to post a Charge Reversal Against the Selected Services? should be used ONLY when the charge has been closed/claimed and there are NO transfers/adjustments/payments posted.
  • If the service has been claimed and needs correction, it should not be deleted until after receiving and posting the remittance. If the service is deleted BEFORE the remittance is received and posted for any charges billed out to payors, there will be no way to rebill the corrected claim in myAvatar. In this case, if the guarantor has a manual claim correction process, through a payer portal for example, the correction would need to be processed in that manner.
  • After making all the appropriate reversals and deleting a service, review the client ledger to ensure there is no remaining liability on the charge.
► Delete Claims

When Should I Delete a Claim?

There should be limited reasons why you would ever delete a claim. If a claimed service has already been submitted to a payer, the claim should never be deleted, otherwise issues will occur when the remittance has been received. The most common reason why a claim would be deleted is if the user created claims and the claim was rejected. In this scenario, the claim can be deleted, the service corrected, and then the claim regenerated. If an entire file of claims is rejected by a payer, all claims can be deleted by the 837 file.

► Progress Note Correction

When Should I Use Progress Note Correction?

The Progress Note Corrections form should ONLY be used by staff who have been properly trained for its use. The recommended practice is to give access to this form only to Billing Staff Users, as this form provides the option of deleting the associated service, and with this ability comes great responsibility. As mentioned above, services should be deleted only in certain instances, so the user must know how to identify whether the charge should or should not be deleted. It will require the user to review the Client Ledger to determine if the service has been claimed and to determine if there are any payments, transfers, or adjustments prior to using the form. 

In order to use the Progress Note Corrections form in these scenarios, the Charge Reversal for Progress Note Corrections field must be populated.

► See Also