Setup
Adjustment types
Set up the kinds of balance adjustments your clinic posts, and which ones need a manager's approval.
An adjustment changes a balance without a payment: a contractual write-off, a courtesy discount, a refund. Each one has an adjustment type, which says how it moves the balance and when a manager must approve it.
Open Setup > Billing setup > Adjustment Types.
What a type holds#
- Category: the reporting bucket, such as contractual, courtesy or bad debt.
- Direction: Credit lowers the balance (write-offs and discounts); Debit raises it (refunds and reversals of an earlier credit).
- Posts to: insurance balances, patient balances, or both.
- Approval: never, always, or over an amount. Approver must hold names the permission the approver needs.
- Largest single adjustment: an optional limit on one adjustment of this type.
The built-in types#
Every clinic has these types. You can rename them and change their amounts, but their category, direction and balances stay fixed, and they cannot be deleted.
| Type | Posts to | Approval | Limit |
|---|---|---|---|
| Contractual adjustment | Insurance | Over 25.00 | None |
| Denial write-off | Insurance | Over 25.00 | None |
| Timely filing write-off | Insurance | Over 25.00 | None |
| Small balance write-off | Patient | Over 25.00 | 5.00 |
| Courtesy adjustment | Patient | Always | None |
| Bad debt | Patient | Always | None |
| Refund | Insurance and patient | Always | None |
| Correction | Insurance and patient | Over 25.00 | None |
By default, approvals go to people who can approve adjustments, which the Billing Manager role includes. The built-in Contractual adjustment type always stays active, because remittance write-offs post with it.
How approval works#
When someone posts an adjustment whose amount is above the type's approval amount (or any amount, for a type that always needs approval), it waits for approval before it changes the balance. If the person posting it already holds the approver permission, it posts right away.
Contractual and correction adjustments that arrive on a remittance post without approval; the approval amount applies when someone enters them by hand.
Add your own type#
- Click New Adjustment Type.
- Enter a Name and, if you like, a Description.
- Choose the Category, Direction and Posts to.
- Choose when it needs Approval and, if it does, the permission the approver must hold.
- Optionally set the Largest single adjustment.
- Click Create Type.
Retire a type#
Turn off Active to stop offering a type; adjustments already posted keep it. You cannot turn off a type that an active posting rule writes off with: change or turn off those rules first. A type that a posting rule names cannot be deleted, only deactivated.
Export and print#
Click Export CSV to download the list as a spreadsheet file, or Print for a PDF of the list. See Import, export and print.