The following information provides guidance on managing partial payments within the Bulk claim file.
These are the topics on this page:
Introduction
As part of the processing of the remittance file, brevity will update the status of the provider invoices contained within the batch based upon the PRODA status listed within the remittance file. Partials payments are identified as being a payment that has been successfully processed by PRODA with Brevity setting the status of the provider invoice to Partial Payment when the amount remitted back in does not reconcile with the amount of the original provider claim.
Through the Organisation record you can set a tolerance that will prompt the remittance process to treat a partial payment as having been PAID.
Processing a Partial Payment
There are two approaches that can be taken with the processing of Provider claims that have only been partially paid.
Manual Claim
This process involves making a manual claim within PRODA for the difference and then awaiting payment to your bank account. One the Brevity side you can update the invoice status from Partial Payment to Paid thus allowing for an update of the remittance amount to reconcile with the claimed amount.
It is recommended that you include information on the comments field of the invoice, to the affect that a manual claim for the difference was processed through PRODA.
Upon receipt of confirmation that payment for the invoice difference has been processed, download your ABA file for the batch within Brevity and process that through to your nominated financial institution.
Partial Payment provider claim
This process involves firstly calculating the difference for the partial (claimed - remitted amounts) . Establish following by establishing a new provider (partial) invoice within brevity through the Plan Management Invoice list page for the difference, ensuring to include the invoice reference + append appending perhaps -1 , it would and uploading the original invoice. It would also be appropriate to include a comment on the partial provider (partial) invoice.
Adhere to the invoice approval process, process the provider claim through to a claim batch, observe observing the steps or on claim submission and the processing back in of the remittance.
In respect of the claim batch that listed the partial payment on the invoice preserve the invoice status , I would update as PARTIALLY PAID, and it is recommended that the comment field be updated with details of the second invoice that was raised for the partial amount.
For this the original batch download your the ABA file and process that through comm bank. it through to your organisations nominated financial institution.
In relation to the partial invoice that was raised, once the remittance has been processed back into brevity and the invoice status has been updated as PAID, proceed with download the download your ABA file and process that it through to your organisations nominated financial institution.