In situations where providers need to make adjustments to entered EOB's, those adjustments can be made using the Enter Insurance Adjustments page.
To access this page, click "Claiming" in the EIBilling.com menu, then drop down to click "Insurance," then "Enter Adjustment."
Providers can then search by child last name, authorization number, NYEIS reference number, or service date range to pull up claims.
The screen will list any claims that match the search. The provider can then click "Select" to select the claim that needs to have adjustments entered.
The screen will then display the claim information, including the date billed, the status of the claim with the insurance company, the amount billed, the amount paid by the insurance, and the CPT code. If more than one CPT code was billed on a claim, this will be listed on separate lines.
Providers should select the correct insurance policy from the "Insurance Policy" drop-down menu, enter the adjustment to the claim, and enter any Notes to help keep track of adjustments or reasons adjustments were made.
The Adjustment amount should be the difference between the original amount entered and the total amount ultimately received from Insurance. If the amount ultimately paid by the insurance company is less than originally reported, the adjustment should be entered as a negative amount. If the amount ultimately paid by the insurance company is more than originally reported, the adjustment should be entered as a positive amount.
Click "Enter" to save the adjustment.
