Dynamic Adjustment Code Mapping
Adjustment Code Mapping allows for the fully customizable of the way GoRev handled Remark codes when posting via 835.edi posting file. This includes
- Force specific adjustment codes to map to a patient responsibility instead of the default behavior of adjusting off the balance
- Change an adjustment codes category to any other category
- Set a specific followup status
- Drop the entire adjustment
To access this in GoRev go to Admin –> Lookup tables –> Select either Adjustment Codes or Remark Codes.
Once selected the below window will populate on your screen
Double click on the numeric adjustment code you wish to alter and the window shown below will appear.
From this window you will be able to set the logic on how GoRev will process the remark code for the server or by individual payers, automatically set follow ups status depending on the remark code as well as update the remark code description,
Set Follow Up
The Set Follow up drop down contains all of your custom followup statuses. Setting a value here will trigger the system to automatically change the accounts follow up status to the status you specify. Note, it will automatically change the actual follow up date currently set on the account to today's date. This will override any existing follow up date on the account. It does preserve the existing biller if one exists.
Posting Rule Sets
Within this screen you can also add rules to override default behavior.
Category There are four options here (Any, CO, OA, PR, PI). Setting it to Any means this rule will fire for any of these code prefixes. In our example screenshot we are on CAS code 116. If we set Any this means the rule will fire on CO-116, OA-116, PR-116, and PI-116.
Action There are four actions available:
- Change = Change this CAS code to a new cas code. In our example, we have changed any iteration of CAS 116 to PR-1. Thus going forward any time the 116 code is seen it will automatically post it to patient deductible (aka PR-1)
- Drop = Drop the entire adjustment from the batch automatically at import
- None = Reserved for future use
- Zero = Automatically set the adjustment amount to $0
Once you have your rule configured click the blue + button to add it to the current rule set for this code. This applies server wide to all GoRev units. If you need to delete a rule set simply highlight it in the list and click the Red X.