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"WO>" in the blue dotted box

Kayla Kenworthy 2 years ago in Billing/Electronic Modules updated by Missy (Care Team Manager) 2 years ago 2

Hello!

I have an ERA  that shows no amount paid, but when I open the claim, it was that $41.60 is paid. I have the blue dotted box with multiple listings in it...for example:


WO>20170405 PR(Claim number here)   $Amount


I know sometimes these are used for interest, but what does the WO mean and how can I pay the claim without having this ERA overallocated?

This is how we work them: Note the FB portion.

http://www.insuranceclaimdenialappeal.com/2012/08/what-is-wo-withholding-and-fb-forward.html

what is WO - withholding and FB - Forward balance with exapmple

PROVIDER ADJ DETAILS 

The provider-level adjustment details section is used to show adjustments that are not specific to a particular claim or service on this SPR. 

PLB REASON CODE – This field indicates the various provider-level adjustment reason codes that may be used. Examples include: 

• 50 – Late charge – Used to identify Late Claim Filing Penalty. 

• L6 – Interest owed – Used for the interest paid on claim on an RA. 

• WO – Withholding – Used to recover previous overpayments. A reference number (the original ICN) is applied for tracking purposes. The WO amount is subtracted from the check amount. 

• FB – Forwarding Balance – Reflects the difference in the payment between the original claim and the overpayment/adjustment to the original claim. An FB will be on an RA any time a claim has been overpaid/adjusted. This amount does not reflect a withholding on this claim. Providers should receive a letter requesting this amount and instructions for refund. If the refund is not received in approximately 45 days, the amount will be reflected as a “WO” on a future remittance. 

When the adjustment shows a corrected payment of less than the original claim payment, an FB reflects a negative amount. When the adjustment shows a corrected payment of more than the original claim payment, the FB reflects a positive amount. 



https://support.procentive.com/Biller/Payments/Post_Interest

Post Interest

Last updated11:42, 20 Sep 2017


Table of contents

Overview

Interest may appear on an EOB or an ERA. Many times you will not know which client or staff member the interest payment is for; therefore, we recommend posting it in the Refunds/NSF Module as Interest.  This article will walk you through how to post interest correctly.

Where Interest Will Appear

The interest will be noted in the top left corner of the ERA, in a dotted blue box with a code L6. L6 in ERA Module - full screen.png  

Where to Post

You will post the interest in the Refunds/NSF Module.  The interest that a payer has paid you is essentially an overpayment; it will be left over on an ERA or EOB as an unallocated amount.

  1. Go to the Refunds/NSF Module
  2.  Click Add.
  3. Refund to:  Choose Payers.
  4. Payer:  Click on the pick list  pick list.png
    • The Select a Payer window will open.
  5. Choose the correct payer.
    • All unallocated credits that exist for this payer will now appear in the bottom of the refunds window. posting interest add refund window.png  
  6. Reference:  Enter Interest.
    • You can also include a payment/ERA reference # if necessary
  7. Note:  Optional
  8. Type:  Choose Interest
  9. Date Posted:  Will default to today's date, but you may enter a different date. 
  10. Locate the interest/overpayment entry below.
    • The unallocated field will tell you how much money is available on each payment reference.
  11. In the Refund column, enter the amount you wish to contribute towards the interest.
  12. Click Save.

Hello,

Procentive has some great features that can help you track back to that overpayment.  While in the ERA, click on one of the "payments" links that you find under a DOS. That will open the Payments window; draw your attention to the upper right section for that payer to see if there are Overpay Credits or Takeback Credits.  If you see money there, click on the dollar amount to open another report explaining which ERA that overpayment is tracked to.  If you can determine that, then you can determine where to pull the money from to allocate the DOS on the ERA.  If you need help, please send a ticket to our Support Desk.  We can then use your specific data to point you in the right direction.  Thanks!