Andres Explains What to do When you Receive More than Estimated in Eaglesoft
Question: Insurance Paid More than allowance. Should I:
A) Edit the Original Date of Service and Change the Fee to the New Fee.
B) Something Else
Answer: ANTHIN' BUT A!!!!
(Say) your Standard Fee for a Prophy is $105 and your "allowance" is $59. You post the service and $59 is the Estimated Insurance based on 100% Preventive coverage.
Now you get an EOB for $60!
You can't post $60 since it would leave the Patient with a Credit Balance and Eaglesoft won’t allow you to post more than the total of the Fee without warning you there will be $1 Unassigned. In some situations, Eaglesoft will not allow you to post an amount greater that the Fee.
Here is what I would do:
1) Post a Payment of $59 (closing the claims)
2) Post a Debit Adjustment of $1 (I like using a "Provider Adjustment for – Fee Differential" or “Fee Schedule Correction DOS XX/XX/2024” Adjustment type) impacting Production to the Provider who did the original Service. Patient now has a $1 balance.
3) Post a $1 Account Payment using Insurance Check as the Payment Type and the same check number. Now Patient’s Balance is $0.
4) Go fix your Fee Schedule.
The time to change anything is in the Account “today” and NOT by changing anything from the Date of Service.
PLESASE. PLEASE. PLEASE, don't edit the original transaction. This will cause the original Service NOT to be "edited" but to be DELETED and replaced and will create Production Credits and Debits. You will see a line item in the Account: "Service D0000 was Modified. Aging Date of Service was Changed to 00/00/00 to 00/00/00"
You will also see a line item in the Day sheet labeled “Deleted Service” and in the Deleted Transaction report.
DISCLAIMER:
This is a resource guide and all decisions on each dental office setup should remain the sole decision of the dentist/owner of the practice. Eaglesoft is a registered trademark of Patterson Dental Company. All other software or products mentioned are the property of their respective owners. Although Andre Shirdan was an employee of Patterson Dental, he is not associated with Eaglesoft or Patterson Dental Company or endorsed by Patterson or any other Company Mentioned in this blog
