Underpaid Items
This feature will assist the biller, Office Manager, and/or provider in identifying claims that the insurance payer did not process with the expected allowed amount.
Allowed Amount = amount paid by the insurance company + the amount the patient owes. This amount is less the contractual adjustment from the billed charges.
Billed charges - contractual adjustment = allowed amount
Allowed amount = amount paid by the payer + the amount owed by the patient
- Under Billing > Fee Schedule, you add a base price for the service and also add the expected allowed amount and payer ID. To add the expected allowed amounts for multiple payers, multiple entries will be required.
As ERAs/EOBs are posted, the DrChrono system will verify that the allowed amount matches what has been entered as the "expected reimbursement". If it does not match, the system will list it under Billing > Underpaid Items so it can be followed up on. Ensure that you enter the allowed amount, and not the actual money received from the insurance company.
This section allows you to filter the report by Date of service, CPT/HCPCS/Custom Code, and Insurer, and Compare by Paid/Allowed. You can view the appointment by clicking on the Date of service and it will direct you to the Billing Detail Screen.
