A claim can read as paid long before its financial impact is fully accounted for. Provider-level adjustments often arrive disconnected from the transactions they reference, with payer data that isn’t always consistent. The answer isn’t automating the decision. It’s automating the path to it: finding, connecting, and routing each adjustment for review.
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Efficiently Managing Provider Level Balance Adjustments (PLBs)
What Are Provider Level Adjustments? Provider Level Balance Adjustments (aka PLBs) are used to convey adjustment information in 835 files that can increase or decrease healthcare provider payments. It can be confusing to follow and determine what is truly owed for a claim because overpayments are often made by healthcare […]
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Streamlined PLB Adjustments with Payment History and ICN
RCMS automated workflows and worklisting tools can increase efficiency, improve data accuracy, generate work queues and many other time-saving benefits. Identifying Provider Level Adjustments (PLB) within your ERA payments is just one example of how systems integration and workflow automation can be utilized to reduce and often eliminate manual data-entry […]
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