Add Account Override Data

Once you determine the account number and value you want to override, you must verify that the account information is correct and provide the override data to save the change.

The display of the Account Override page varies, depending on the features that are enabled for your facility. With the Coordination of Benefits (COB) enabled, this page allows you to override multiple associated accounts at one time. Consequently, in the COB view, many of the fields on this page display in a grid so you can view details for all of the selected accounts.

Note: Account overrides will only apply successfully when applied to an account with a processable UB. When the override process attempts to reprice the account, the reprice fails if a processable UB is not found, and the override remains in a pending status.

Use this procedure to verify the account information and add an override value and comment about the change.

  1. Access the Account Override Verification page.
    1. Select Go To > Overrides > Add Account Override. The Add Account Override page opens.
    2. Type the number of the account you want to override in the Account Number field.
    3. Select the type of value you want to override from the Field Types list.
    4. Click Add Account Override.
    5. If there is only one account for the entered account number, The Account Override Verification page opens.
    6. If there are multiple accounts for the entered account, a list of accounts displays.
      • Select the account or accounts you want to override in the Select column.
      • Click Add Account Override. The Account Override Verification page opens.
  2. Review the account information to ensure the displayed account is the one you want to override.
  3. Type a new value for the field you want to override in the Override Value field.
    • If you are forcing a reprice or voiding the account, you do not enter a new value.
    • If you are overriding a primary procedure code, you must type an ICD-10 code for the new value.
    • If you are overriding a payor code, the new code must match one of your existing payor codes exactly. To look up your list of payor codes, refer to View Payor Mapping by Payor Code.
  4. Type a reason for the change in the Comment field, or follow your internal procedure for such comments.
  5. Click Save Account Override.

The following table describes each of the fields on the Account Override Verification page.

Field

Description

Account Number

Patient account number (for UB claims) or insured ID (for CMS-1500 claims)

Admit Date

Date of admission for the account

Comment

Comment typed by user who created the override

Dates of Service

The range of date of Service From and date of Service To for the claim

DRG

Diagnosis Related Group code

Field to Override

Name of the field that is to be overridden

Latest Account Override Made By

User ID of the individual who performed the last account override

Latest Account Override Made On

Date of the previous override

Latest Account Override Value

Last value added by override

Old Value

Value of the field before the override

Override Value

New override value

Override transaction plan IDs consistent with account

This check box is checked by default. Clear this check box only when this option should not be included with the account override.

This option enables the new payor code to be applied to all the transactions that are currently associated with the billmast record being changed.

Payor Class

Indicates whether this account is for a (P)rimary, (S)econdary, or (T)ertiary payor. This column only displays if Coordination of Benefits (COB) is enabled for your facility. For more information, refer to Coordination of Benefits.

Payor Code

Payor code associated with the product

Payor Name

Name of the payor

Primary Diagnosis

Primary diagnosis code. This field provides a link to additional information about the code.

Click the link to view basic information about the code.

KnowledgeSource subscribers can log in to KnowledgeSource to view detailed information about the code.

You must be a KnowledgeSource subscriber to view ICD-10 code information.

Primary Procedure Code

Code for the primary procedure performed

Reprice Type

Indicates the reason the claim was repriced separately from other claims for this account. This column also helps to distinguish between multiple claims on an account. For more information about reprice types, refer to Multiple Reimbursement Calculations > Reprice Types.

Total Charges

Total charges for the account
  • Add Account Override displays the Add Account Override page.
  • View Account Override History displays the Account Override History page. For more information, refer to View Account Override History.
  • View Claim Override History displays the Claim Override History page. For more information, refer to View Claim Override History.
  • View Account Audit displays the Patient Account Audit page. For more information, refer to View the Patient Account Audit Page.