Adjustment and Payment Codes
The Current Bad Debt adjustment code.
What is a 3345?
The number assigned to every line item in Professional Billing
What is a Transaction or Tx number?
The number assigned to each hospital encounter
What is a HAR?
The person who must give approval for a member to lower their monthly payment on an established payment plan.
Who is a TM/HPSS?
This is the system payment plans are created in.
What is KP HealthConnect?
The code applied to bring the total charges to the allowed amount, or the member rate.
What is a 3023?
The tab that displays information such as Department and Location, Provider, Diagnoses and Modifiers
What is the Tx Detail/Summary tab?
The tab that displays the Statement History section
What is the Acct Summary tab?
The person financially responsible for the balance on the account
Who is the guarantor?
36-months
What is the most months allowed for a payment plan?
The code for a payment made over the phone or by mail
What is 1028?
The tab in HP CHATS that displays member liability and the ICN
What is the Tx EOB Info tab?
The line that needs to be expanded to locate the ICN
What is the Internal Claim Payment (1094)?
The document that shows the member accumulations and what services the member has received.
What is an EOB?
This is the only place you can see which drug benefit codes are subject to the separate drug deductible.
What is Foundations
The code to report a bad debt reversal
What is a 5004?
The tab where you will find the adjustment codes & any payment codes attached to the charge.
What is the Matching Txs tab?
The tab that includes balances, charges, payments, and refunds
What is the Tx Inquiry tab?
The system that adjudicates benefits and tracks accumulations
What is Tapestry?
This tab in HP CHATS, shows all dependents currently & previously covered on the Guarantor account.
What is the Coverages tab?
The code for an Internal Claim payment
What is 1094?
This gives the billed service a different meaning or adds additional information.
What is a modifier?
This section displays when a Rev code is expanded.
What is the Itemized Charge Listing?
Never quote a balance when this Hospital Account Status is present.
What is the DNB status?
Next step after you've confirmed there is no KP error and explain to the member that they defaulted on a payment plan.
When do you refer the member to USCB?