Occasionally a payment may get applied to the wrong patient account or an unapplied payment may need to be applied to another account in the Ledger. This article addresses some of these scenarios, and how to resolve them by using Positive and Negative Adjustments.

What are Adjustments?

The most important tools in your arsenal in this situation are the Positive and Negative Adjustment, located in the Other drop down menu in the Ledger.

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Positive and Negative Adjustments are frequently misunderstood. An Adjustment, true to its name, adjusts the balance or portion up or down.
If you wanted to increase the balance of an account, you would use a Positive Adjustment.
If you wanted to reduce the balance of an account, you would use a Negative Adjustment.

Common Problems and Solutions

Below are a list of many common ledger scenarios and their solutions. We'll start with some very simple issues that doesn't require the usage of Adjustments, and then address situations that require the usage of Adjustments.

I applied a payment to the wrong account or with the wrong amount today! How do I fix it?

This scenario is the easiest to fix. If you have posted a payment on the wrong account today, the easiest solution is to simply unapply the payment and then delete the payment line item by clicking the payment in the Ledger and pressing the Delete key. Then simply repost the payment on the correct account or in the correct amount.

I have a patient payment that needs to be applied to a different patient on the same account!

 First, unapply the payment. The easiest way to do this is to click on the payment line item, and then use the Other drop down menu to select "Unapply Selected Payment".

Once you have done this, now you can  apply the payment to any charge on the Account with an open patient balance. Scroll through the list of available charges, looking at the Patient Name column to apply the payment to the correct Patient. Enter the desired applied amount into the Payment column.

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I have a patient payment that was posted on the wrong account that I just noticed from a week ago. How do I transfer that patient payment to the correct account?

In order to resolve this situation, we'll need to create a Positive Adjustment on the wrong account for the amount of the payment. This will increase the balance of this Account to account for the mistaken payment.
Then, we'll create a Negative Adjustment on the Account the payment was actually intended for, which will decrease the balance by the amount we want.

Let's handle this step by step.

1. Positive Adjustment: 

   • A Positive Adjustment requires that you tie it to a charge. What we recommend is that you create a 0.00 dollar charge to associate with a Positive Adjustment.  This will create a separate line item that will serve as an explanation. We typically use "Balance Transfer" or "Balance Forward" for the name of the charge code. This has the added benefit of being able to locate Balance Transfers on Production Reports.

     • If you don't have a 0.00 charge already set, you may want to add one to one of your Fee Schedules. You can do this in the References Ability > Fee Schedules.

   • Once you have a 0.00 charge, select the charge, then select "Positive Adjustment" from the Other drop down menu.
     
     

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   • Enter the amount of the payment in the required "Positive Adjustment by Amount" field, then select an Adjustment Type. We recommend adding a Balance Transfer or Balance Forward type, for further assistance with tracking. Also, add in a Description of Adjustment that includes the account number where you are transferring the balance to. A brief explanation of the circumstances wouldn't hurt either, but you could use a Comment to thoroughly document the reason why.

   • Finally, you'll want to make sure that the payment that is still accidentally posted on this account is applied to the newly created Positive Adjustment. This ensures that the payment amount cannot be used for other charges. 

2. Negative Adjustment

   • Now that you've effectively taken away the payment from the first Account, you can then post a Negative Adjustment on the second Account. This doesn't require a charge to tie the adjustment to; Negative Adjustments live alone. Navigate to the second Account, and select "New Negative Adjustment" from the Other drop down menu.
     
     

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   • The Negative Adjustment window is very similar to the Payment window, because Negative Adjustments behave just like Payments; You apply them to Charges. Enter the Total Amount of the Payment into the "By Amount" field, then use the Adjustment Column in the Charges Table to apply this Adjustment to a specific Charge.

   • You'll also want to add an Adjustment Type (visible at the top of the Adjustment Window). Balance Forward or Balance Transfer are good terms for this.

   • Finally, you may want to add a comment tied to this adjustment, describing where the transfer went to.