Editable 835s

This feature is currently in Limited Release to a select group of Members and will be gradually rolled out in the future.

On the Release 835s page you have the ability to: 

• Identify errors and make edits during the posting process 
• View patient notes and visit info during the editing process 

Allowing these edits will reduce the number of errors that appear on the Error Report.

Edit an 835

1. Open the Payments menu and select Release 835s.
2. The Company field is populated with the company name you are logged into. To release an 835 for another company, you must switch to that company in order to proceed. Enter a Check Number or an 835 Date Range. Both can be entered, but only one is required. Click Search to view a list of available 835s based on your search criteria.
3. From the search results, 835s with any associated errors will be highlighted in red and the number of errors will be displayed. Select the drop-down arrow to view the 835s in an editable format.

   

    

   Note: The number Errors may not always be accurate due to updates the charges have undergone after an 835 was received.
4. On the Release 835 Check Details page, patient cards are displayed for all patients within the 835 file that have workable errors.
   1. Patient Name
   2. Patient ID
   3. Account Note Icon: Allows you to add/view Account Notes for the patient without navigating to their chart.
   4. Case Title
   5. Insurance details
5. Hover over the Error Badge to review the error reason. For this example, this patient has two errors. The first one is the Account has a payment sticky note and the second is Units Do Not Match for the displayed DOS and CPT code.
6. To view the 835 details, select the drop-down arrow to expand the Patient Card, the card is further broken down by individual Claim ICN and Date of Service.
   1. Non-Editable Fields
      1. Error Indicator: Displays the pre-determined errors this charge will have if no edits are completed
      2. CPT Code: Displays CPT code as received on the 835
      3. Charge ID: WebPT Billing' Charge ID the payments and adjustments will be posted to
      4. Units: Displays the number of units as per the 835
      5. Modifier: Displays the modifer(s) as per the 835
      6. Billed: Amount listed on the 835 as being billed to the insurance
      7. Allowed: Amount listed on the 835 as being the amount allowed to be billed
      8. Expected: If set up in Expected Rates, displays the amount expected to receive for this charge. If less than the allowed amount, the line will display in red. 
      9. Balance: Calculated as the (current balance - payments and adjustments) that were taken as they were listed on the 835. This value does not recalculate as you make edits to the charge line.
      10. Claim Status: Displays how the insurance processes the claim and does not indicate how our system processes the charge.
   2. Editable Fields
      1. Payment Sticky Note (if applicable): Displays any payment sticky notes that are active on the patient account. By default, no payments or adjustments will post to a patient's account that has a payment sticky note. To allow these to post and for edits to be made, click Post and exclude error checkbox. 
      2. Mark as worked: Check this box to indicate that the error has been worked on. Once checked, the line will turn blue and the Error Badge will reduce in value.
      3. Post and exclude error: Check this box to post the 835 regardless of any changes made and to exclude the displayed pre-determined error(s) from the Error Report. Note: Additional errors may generate after the 835 is released and will display on the Error Report.
      4. (+) and (-): Allows you to add or remove adjustment lines for the charge. For example, if there are multiple adjustments on a charge and you want to remove an adjustment from posting, click the (-) to delete the line.
      5. Paid: Lists the amount being paid by the insurance on the charge
      6. Adjustment: List the amount being adjusted by the insurance on the charge. If there are multiple adjustments then additional Adjustment Qualifier and Reason fields will display.
      7. Adjustment Qualifier: Displays the qualifier related to the adjustment amount as seen on the 835
      8. Reason: Displays claim adjustment reason code associated with the adjustment amount and adjustment qualifier as seen on the 835
      9. Insurance Balance: Pulls from Payer Rules that are applied to the charge line. This field determines what to do with any balance that is remaining.
         1. Keep Current: Once the 835 is posted, the balance on this charge will not move to a different payer.
         2. Transfer to Next: Once the 835 is posted, the balance will move to the next payer in line that has no payments/adjustments posted, which could include the patient.
      10. Patient Balance: Pulls from Payer Rules. This field determines what to do with the balance that is transferred to the patient. Note: If the balance is being transferred to additional insurance, the options selected in this field will not apply.
          1. Keep: When a balance is transferred to a patient, no additional adjustments are taken
          2. Adjust: When a balance is transferred to a patient, the remaining balance of the charge is adjusted off in order to leave the charge with a zero balance.
      11. Patient Balance Adjustment Code: Pulls from Payer Rules. If Patient Balance is set to adjust, a selection must be made from the drop-down. The selected code will be tied to the amount that was adjusted off. Note: This will appear on the charge as a patient adjustment, NOT an insurance adjustment.
7. To resolve the error, make the necessary changes to the editable fields.
8. Select Save & Release to process your changes.
9. Enter a Deposit Date (Batch number is optional), then click Save & Release.
10.  Once a file is released, navigate to the Error Report to review.