Units Do Not Match

This occurs when the billed units do not match the units paid by the insurance. When researching this error from the Error Correction page, you are looking to determine whether the insurance has under or over-paid for the charge line. 

Note: This is a soft error meaning the payment did post to the patient’s account. Corrections may be required, with the procedure depending on whether you were under or overpaid.

Researching the Error

Scenario: We received a Units do not match error report for 97110 on Date of Service 5/29/2008 for our patient Julian. 

  1. First, search for the patient using the Patient Search bar.
  2. Once a patient has been selected, navigate to the Payments menu and select Error Corrections.
  3. Enter the search criteria and click Save.
  4. Here we can see that we billed out 97110 for 3 units, however, that charge line is grayed out, indicating it is inactive. Below that charge line, we can see we billed out 97110 for 2 units for the same Date of Service. This occurs when the therapist completes an addendum and changes the units.
  5. As a payment poster, you’re looking for two things:
    1. First, did they pay to contract? It may not matter how many units billed if they paid the contracted rate. 
    2. Second, did they underpay for the charge or drop a unit? 
  6. For this example, they paid the contracted rate of $75 per visit, so it doesn’t matter that we charged them for 3 units instead of 2. 

Underpaid Charge Lines

If the payer underpaid/dropped a unit, and you want to leave that charge line open, follow these steps.

  1. Search for the Patient and then navigate to Error Corrections.
  2. Enter the Date of Service and/or Charge ID you’re researching. Check the Show Inactives box, then click Search.
  3. Click on the Charge ID for the charge that was underpaid.
  4. Remove the value in the Adjustment Amount field.
  5. From the Transfer Ins Code drop-down, choose the insurance to assign the amount back to the insurance.
  6. Click Save.

When can I Ignore this Error?

This error can be triggered by the way the payer chooses to pay. For example, if the insurance reimburses a flat, contracted rate and does not pay per billed unit, you’ll receive this error. Also, if they don’t return units on the EOB or split units on the EOB, this error will also appear. In these instances, you won’t need to take action. That being said, until you familiarize yourself with the insurance’s behaviors, you should research this error to confirm you aren’t being under or overpaid.

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