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Crediting Process Overview

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Credits are only applied during the compile process and only to those charges included within the same batch. That being said it is important that before a final compile is done through a specific date of service that the end-user has confirmed that all credits through said date have been sent from the ancillary system to myAvatar PM.

In order for a credit to be applied, it must match the charge on the following criteria:

  • Date of Service
  • Episode
  • Service Code
  • Service Provider
  • NDC (if applicable)
  • Order Number (if applicable)
  • That the credit service unit total is not greater than the charge service unit total
  • That the credit dollar amount is not greater than the charge dollar amount

Only charges that have both a unit and dollar amount greater than zero will be applied to the ledger during posting.

Note: The service codes within the myAvatar system should be defined with a Type Of Fee equal to User-Defined with Minutes Per Unit equal to "1". If not then the system will file each charge with a default unit value of "1" instead of the unit value sent by the ancillary system.

  • No credit will be applied to a charge that has one or more payments and/or adjustments posted against it, that has already been claimed, or that has been deleted.
  • If the charge is credited in full, the charge will be deleted from the system.
  • If the charge is partially credited, then the service units/dollars will be changed to reflect the adjusted amount. In addition, for any matching National Drug Codes, the NDC quantity will be adjusted.

Note: If a credit is applied to a charge that is already on the client ledger, the charge will be included in the report but will have an asterisk (*) appended to the service code. The asterisk indicates that the posting of that line item will not result in the creation of a new charge, but the application of one or more credits to an existing charge.