A/R question about writting off claims that are being appealed

jocarter

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Is it a normal practice to adjust off a balance at 90 days, even if the claim is pending an appeal/redetermination? I am finding multiple examples where documentation clearly supports the charges, so we should be getting payment.

Any feedback on this would be greatly appreciated.

Merry Christmas!!!

Thank you,
Jolene Carter, CPC, CPMA
 
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It's not a normal practice to write off balances that you are still owed and expecting to collect, but different practices might have different policies and procedures for accounting purposes as to how they choose to handle this. I know that some practices feel that the likelihood of collecting a balance more than 90 days old is low so they may not want to inflate their A/R by keeping these on the books. In my experience though, it's not a good idea to write off something that soon because once you do, it's much harder to track it and pursue the payment.

As far as 'falsifying' an A/R, that's usually not really a concern unless you're reporting that information to outside entities such as shareholders or financial companies that use your A/R as a representation of your assets (e.g. as collateral for a loan or estimate of the company's net worth). In most cases, A/R is an internal accounting performance measure, but that would be a better question for your accountants rather than for the coding forum.

Hope that helps, Merry Christmas to you too!
 
Hi Jolene :)
Simple answer, nope!
My first thought is that it is probably the AR person being lazy. But, to give the AR person the benefit of the doubt, maybe doing this has something to do with the provider's policy/preference.

Some payers won't even decide on a 1st appeal/reconsideration until 60 days from date it is received (Novitas). If I don't agree with a 1st appeal/reconsideration denial, I go for the 2nd level appeal & that could take another 30-60 days. If I really believe the charge should be paid, my provider agrees & there are appeal options past that level, I go for it.

Hope
 
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