What is an adjustment transaction?

An adjustment transaction in medical billing refers to a change made to a patient's account balance that reflects a modification in the amount owed. This could occur for several reasons, such as:

• Insurance Adjustments: After an insurance claim is processed, the insurance company may deny certain charges or apply a discount, leading to a reduction in the amount the patient owes.

• Patient Discounts: If a provider offers a discount for prompt payment or for uninsured patients, this would be recorded as an adjustment.

• Payment Errors: If an error is found in previous billing, such as double billing or incorrect coding, an adjustment may be necessary to correct the account balance.

• Contractual Obligations: Some providers have agreements with insurance companies that specify the amount they can collect from patients, which may require adjustments to the billed amount.

Get started

Click Utilities.

Select Practice Setup and click Adjustment Transactions.

Select New Adjustment Transaction in the top right of the screen. 

Choose one of the following Master Transaction types:

• • Insurance Adjustment: This type of adjustment is made to the insurance claim.
  • Patient Adjustment: This adjustment type is made to the patient's balance.

If you're creating an insurance adjustment select your denial code from the claim Claim Adjustment Reason dropdown list. 

If you're creating a patient adjustment you can also select a denial code from the claim adjustment reason dropdown list or create your own by adding a name in the Code section. If applicable, enter a description into the Description field. 

Click Save.

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