MA Recalculate Patient Pay Adjustment for a Provider Change

Use this procedure to recalculate previously authorized Patient Pay segments when there is a provider change for an institutionalized individual.

Process Steps:

The Patient Pay Adjustment – Provider Change page displays.

1. In the Patient Pay Adjustment section:

1. • Enter the case number you need to search for in the Case # field.
   • Select the EDG # you want to search for from the EDG # dropdown menu.
   • Enter the begin date of the patient pay adjustment search in the Begin Date field.

2. Click Search.

1. • The authorized payment dates display in the Authorized Patient Pay Summary section.
   • Click the View icon next to the Patient Pay Segment to view the Patient Pay Details.

3. Click Reevaluate Patient Pay to recalculate the Patient Pay for all payment dates displayed.

1. • The recalculated payment dates display in the Adjust Patient Pay Summary section.
   • Click the View icon next to the Patient Pay Segment to view the recalculated Patient Pay Details

4. Click Approve.

1. • The recalculated Patient Pay details are authorized and updated in the system.
   • Authorized Patient Pay Summary displays the recalculated Payment dates.
   • The approved Date for the segments is updated to the current date.
   • The Notice of Obligation is triggered.

Results of the Procedure:

Patient Pay Adjustment is recalculated.

Updated 10/03/2016