PURPOSE:

To maintain our mission at LHCC, depends on revenue from services provided. To accurately monitor write offs and adjustments of patient accounts.

POLICY:

It is the policy of LHCC to apply contractual adjustments according to insurance. These are called contractual adjustments. To write off a patient balance, prior authorization from the Billing supervisor is required. The correct write off and adjustment codes will be used for tracking purposes.

PROCEDURE:

A contractual adjustment is the amount that the carrier agrees to accept as a participating provider with the insurance carrier.

A write off is the amount that cannot be collected from patient due to several issues. Documentation is required for any patient balance adjustment for auditing purposes. These codes will be monitored for educational training. Notes are to be used with utilizing these codes:

• Bad Debt - This should have documentation from the provider.
• Courtesy Adjustment - This is a highly utilized adjustment, appropriate documentation is required.
• Employee Discount - When this code is utilized, all charges for that encounter must be written off or otherwise not charged.
• Hardship Discount - Should only be used if hardship is documented.
• Invalid PCP - When this code is utilized, review to be performed to ensure that charge was reprocessed appropriately.
• Out of Network Denial - This code will be reviewed for accurateness.
• Physician Authorized Adjustment - Documentation is required.
• Self-Pay Adjustment - Use as appropriate
• Small Balance Write Off - Use as appropriate
• Transfer - Documentation required
• Write Off - Documentation required

Revised 11/2013