Skip to main content

System Maintenance - Posting/Adjustment Codes Definition - Cal-PM

  1. Last updated
  2. Save as PDF

Maintain posting and adjustment codes. These codes are used to define payments, adjustments, or transfers for a client’s liability.

Avatar PM > System Maintenance > System Definition > Posting/Adjustment Codes Definition

Code Basics

  1. In the Add Or Edit Posting Code field,

  • Select Add to add a new posting code.
  • Select Edit to edit an existing posting code.

  1. In the 'Posting Code' fields, select the code from the list or enter a new posting code.

  2. In the Code Definition field, enter the posting or adjustment code description.

  3. In the Restrict Posting With This Code to Single Item Posting field:

  • Select Yes to allow posting payments or adjustments to only a single line item in the client ledger.
  • Choose No to allow posting payments or adjustments against multiple lines in the client ledger

  1. In the Adjustment, Payment, or Transfer field:

  • Select Adjustment to alter a service balance without receiving payment (for example: write-off).
  • Select Payment to post a payment.
  • Select Transfer to transfer guarantor liability.

  1. In the Transfer Type field:

  • Standard Override - transfers the service amount to the guarantor. The service has a billing status of UNBILL.
  • Redistribute (Open) - transfers liability from one guarantor to another. Liability is distributed based on the client's financial eligibility. The service has a billing status of OPEN.
  • Redistribute (Close) - liability is transferred from one guarantor to another guarantor. Liability is distributed based on the client's financial eligibility. The service has a billing status of UNBILL.

  1. In the Are There Guarantors This Code Should Not Be Used With field:

  • Select Yes to limit the guarantors that the code can be applied to (Exclude Guarantors field).
  • Select No to apply the code to all guarantors.

  1. In the Exclude Guarantors field, select the guarantors to exclude from being associated with the code.

  2. In the Error Message for Excluded Guarantor(s) field, enter the error message to display when an excluded guarantor is selected in a billing form.

  3. In the Credit or Debit field:

    • Select Credit to decrease guarantor liability.
    • Select Debit to increase guarantor liability.

  4. In the Security Level field, select the level of security required to access the code. Security level is defined in the User Definition, and User Role Definition forms (RADplus Utilities).

  5. In the Is This A Reversal Code field:

    • Every credit code should have a corresponding reversal debit code.
    • Select Yes to create a reversal code; select No to create a standard posting code.

  6. In the Which Pym/Adj Code Is This A Reversal For field, select the posting code.

  7. In the Allow Batch Cash Posting field:

    • Batch cash posting is set up in the Create Interim Billing Batch File form.
    • Select Yes if the code will be used for batch cash posting; select No if the code will not be used for batch cash posting.

  8. In the Is This Adjustment Code A Contractual Writeoff field, select Yes if the code will be used for contractual write-off

    • This field is used to designate the posting/adjustment code for use in the contractual write-off by batch, in the Contractual Allowance forms in Cal-PM. Selecting Yes will flag the write-off for a contract guarantor where you know before billing that the guarantor will only pay X amount and the rest will not be paid (due to contract pricing).

    • Contractual writeoff adjustments are not looked at by the 837 when reporting other guarantor adjudication information in the CAS segments.

Additional Settings

  1. In the Generate Receipt field, select Yes to generate a receipt when the code is used for payment.

  • Selecting Credit (Credit or Debit field) enables this field.
  • Receipts are set up in the Receipt Definition form.

  1. In the Validate Transaction Date Against Date of Receipt field, select Yes to verify that the posting date and the transaction date are compatible. If the transaction date is closed, the posting code cannot be applied against the transaction.

  2. In the Void Receipt Posting Code field, select the posting code.

  • This code is for a rejected payment receipt.
  • This code is used by the Void Receipt form to generate a receipt for the voided payment.

  1. In the Does This Code Affect UMDAP Liability Distribution field, select Yes if the code affects UMDAP client liability.

  2. In the Is This A Charge Reversal? field, select whether or not this posting/adjustment code will be available for selection in the Charge Reversal Code field on the Delete Service form. This code may then be used to write off liability when a closed service is deleted.

  3. In the Claim Adjustment Group Code (837-2430-CAS) field, select the code. The column "group_code_code = 'Claim Adjustment Group Code (837-2430-CAS)" in billing_pay_adj_history will be updated for services that are NOT claimed when this value is changed.

  4. In the Claim Adjustment Reason Code (837-2430-CAS) field, select the value. The column "adjust_code_code = 'Claim Adjustment Reason Code (837-2430-CAS)" in billing_pay_adj_history will be updated for services that are NOT claimed when this value is changed.
    The ‘Adjustment Group’ fields work with adjustments that are manually posted.

  5. In the Trigger Retro Claim Adjudication Entry in MSO field, select Yes to allow any adjustments filed with the specified adjustment code to create a Retro Claim Adjudication record in myAvatar MSO.
    This field is only visible in systems with myAvatar MSO attached.

  6. In the ERS Posting Code Category field, enter the category for the ERS posting code.

  7. Click File Posting/Adjustment Code.