Charge Left With a Credit Balance
When the 835 was released, the system identified a credit left on the charge. You’ll need to go to Error Corrections and determine if an action needs to be taken on that credit. This can occur for many reasons, some common ones include a duplicate payment was posted, an incorrect adjustment was added, or there were multiple adjustments added to the same charge line.
Additionally, if you determine the credit balance is correct (i.e. in the case of a duplicate payment), you should confirm that the credit is open to the correct responsible party. You can change who the credit belongs to in Error Corrections. Valid credits are typically open to the payer (because they overpaid).
Scenario: Secondary Insurance Adjustment Posted
In this scenario, the secondary insurance adjustment was posted and created a credit balance on the patient's account. This scenario can occur when the secondary wasn’t on the patient’s account when the payment was posted, so the system defaulted to posting the payment as primary. Or, it could be that the secondary was posted manually, and the adjustment was accidentally included. You’ll often see this error in conjunction with the Matching Inbound Payer ID not found error, click here to learn how to resolve this error pair.
Scenario: Same Day PT and OT Treatment
Another common reason charges are left with a credit balance is when the patient receives both PT and OT treatment on the same date, and the two providers billed the same CPT code. In this scenario, the two payments were applied to one CPT Code. To resolve this issue, navigate to Error Corrections and locate the CPT Code where both payments were applied. Delete the incorrectly applied payment/adjustment and then add the payment/adjustment to the correct charge.