Specify an Account to Override
When processing billing information or conducting account research, it is sometimes necessary to change information on an account. By using the Account Override feature, you can make the changes necessary in Contract Manager without having to resubmit the claim.
If your facility uses the online account override function, and if you are authorized to use it, you can change existing account data online. Use this procedure to specify an account to override.
- To access the Add Account Override page, select Go To > Overrides > Account Override Add.
- Type the number of the account you want to override in the Account Number field.
- Select the type of value you want to override from the Field Types list.
- To override a service type reimbursement value, you must provide the cost or manual amounts to FinThrive.
- Selecting Void Account for FinThrive Repricing changes the payor code to a “dummy” payor code such as ***void***.
- This way, the account record is not literally removed and still appears in Account Override history.
- This selection reverses repricing data (as if the payor code was changed to one not mapped in the system).
- If the account includes more than one admit date, you must pick the one you want to override.
- If you choose to override a service type reimbursement value, and the given account contains more than one eligible service type, you are prompted to select one.
- While all of the account’s service types are listed, only the ones for which FinThrive received cost or manual amounts from your facility are available for selection.
- If you choose to override a service type reimbursement value for an account that only contains one eligible service type, you are directed to the Account and Override Information page.
- Click Add Account Override.
- If there is only one account for the entered account number, The Account Override Verification page opens.
- 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.
- If Coordination of Benefits (COB) is enabled for your facility, you can select one unpriced claim or multiple BILLMAST records to apply an override. For more information about COB, refer to Coordination of Benefits.
- If Coordination of Benefits (COB) is enabled, you can sort and group the accounts that display.
- To sort accounts by a different column, select the name of the column you want to sort by from the Sort By list and click Refresh View.
- To group the accounts by payor class, select Payor Class from the Group By list and click Refresh View. This option is only available if Coordination of Benefits (COB) is enabled for your facility. For more information, refer to Coordination of Benefits.
- Click Add Account Override. The Account Override Verification page opens. For more information, refer to Add Account Override Data.
Note: An error message displays if an account override is not appropriate:
No repriceable claim(s) were found for this Account. An account override is not appropriate since the claim(s) was not able to be repriced due to data errors. See the help for additional information.
This usually means that the claim has not been priced by Contract Manager due to data errors and it has been identified as not able to be processed. Click Add Claim Override to update the claim and enable it for processing.
- View Account Override History displays the Account Override History page. For more information, refer to View Account Override History.
- Add Claim Override displays the Add Claim Override page. Add Claim Override Data.
- View Claim Override History displays the Claim Override History page. For more information, refer to View Claim Override History.
- Add Medicare Override displays the Add Medicare Override page. For more information, refer to For more information, refer to Add Medicare Override Data.
The following table describes each of the fields on the Add Account Override 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 |
|
Billed Charges |
The total charges incurred for the claim or set of claims that have been repriced |
|
Bill type |
|
|
Claim |
Link to vie the claim representation page |
|
Claim Type |
The type of claim from which the contracts are repriced, either a UB04 or CMS-1500 |
|
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 |
|
Expected Discount |
Expected Discount minus the Actual Discount |
|
Field Types |
Select the appropriate field type using the drop down list (DRG is selected as the default) |
|
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. |
|
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. |
|
Submit Date |
Submit date of the claim |