Require the ability to maintain the amount that was billed to MBH on a claim if the ‘Adjust to Paid’ option is selected. This is required in order to see the difference between the amount which was billed vs. the amount actually paid for the claim and represent this accurately within the billing reports being run.
If you run the Submissions report after you have downloaded the remittance file and gone through the reconciliation process, the ‘Amount Billed’ may change if you use the ‘Adjust to Paid’ option (recommended by vendor) if MB Health has upgraded or downgraded to ‘Paid’ amount of the Tariff code. This makes it very difficult to use the report to get an accurate estimate of the ‘amount billed” vs. “amount paid’ at year end.
[Please see attachment for further details.]
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