Medical Billing Forum

General Category => General Questions => Topic started by: bsmedbilling on June 03, 2011, 11:33:56 AM

Title: Appeal Payments
Post by: bsmedbilling on June 03, 2011, 11:33:56 AM
Hello everyone,

Lets say I have a claim that I submitted to Medicare. They paid two of the charges and denied the other two charges. I updated my Practice Management Software with the payments/adjustments then appealed the denied charges. The secondary paid and I updated the system with this information also.

Now Medicare has paid the appealed claims but I am not sure how to enter this information in my PM Software. Do I go back to the patient's bill in the system and redo the payments/adjustments to reflect the new information?

Thanks for your help
Title: Re: Appeal Payments
Post by: pattil88 on June 04, 2011, 06:44:20 AM
Ugh......there are so many different ways practices post these, but I'll give this a shot. First, just a little more info:

1) What practice management billing software do you use?
2) Can you give more detail on what was originally posted on the 2 charges that you had to appeal? (i.e., was a "zero" payment posted to indicate they were originally denied, did the original fees for those 2 charges remain unadjusted on the claim, etc.)
Title: Re: Appeal Payments
Post by: Michele on June 04, 2011, 01:41:07 PM
Yes it varies depending on what PM system and how you've set it up.  In my system I would have entered a partial primary insurance payment and a partial secondary payment and noted that I had appealed the two charges.  Then when the appeal was finalized I would enter that info on the same claim.
Title: Re: Appeal Payments
Post by: arms on June 06, 2011, 06:54:34 PM
Yes you have to go back and reverse the adjustments on the appealed codes that paid and post that payment then resubmit new eob to the secondary and do the same for secondary if they pay additional payment.