Managed Care

Ask the Experts: Provider Level Adjustments

May 14, 2019 3:43 pm

Is there a best practice for handling provider level adjustments (PLBs) in electronic health record (EHR) systems? We experience issues when pointing to patient accounts and with “clearing accounts” where PLBs should clear themselves out.

Answer: It depends on the specific PLB. They come in with different levels of information and different strategies are used to handle them. Some are indeed posted to patient accounts, and others can’t be. Scenarios usually don’t change based on claims processors because the 835 electronic remittance advice is handled similarly across the board. 

This question was answered byRuth Landé, senior vice president, patient revenues, Memorial Sloan-Kettering Cancer Center, and a member of HFMA’s Metropolitan New York Chapter.  

The information provided through the Forum’s Ask the Expert service does not constitute legal advice, even when the advice is provided by lawyers. You need to obtain your own legal counsel for legal advice and consider the laws and regulations that govern your state. The content and opinions expressed are those of the Forum experts, and not that of their employers or of HFMA. HFMA does not endorse the material or warrant or guarantee its accuracy. The responses are based only on the specific facts or circumstances provided. Forum experts cannot be held liable for outcomes related to any information provided.

 

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