Note: This only applies to insurance payments from payers that you are not enrolled for receiving electronic payment reports.
In certain scenarios, insurance payers will run audits on clinicians or organizations to re-assess their financial obligation for claims that have already been finalized. This means that they may end up retracting some of their initial payment, or paying an additional amount. While it's important to make sure that everyone is paid fairly, this can offset your accounting records and may require some adjustments to be made in your SimplePractice account.
If you receive a notice from a payer that they've re-processed a claim and made adjustments to their payment, you can easily reflect these changes in your SimplePractice account.
Here's how to manually enter an adjustment:
- Navigate to the Insurance Payment that needs adjusting.
- Click Edit in the upper right corner of the screen.
- Filter by date range and client name to locate the sessions, as shown below.
- Update the check/EFT number
- Use the authentic EOB from the insurer which outlines the updated coverage as a resource.
- Update the total amount paid, and each of the sessions that need to be adjusted.
- Click Save.
Document the adjustment with Chart Note
After making these changes, we recommend documenting this using the Chart Note feature within the client's file. This will allow you to provide details about the adjustment.