Example Negative Variance

In the below example, the individual charge lines total 0.8 units at $80. Roll-up logic will bill 0.7 units at $70 on the claim. Therefore, during the billing process, a "variance" charge will deduct –0.1 unit at –$10 from the encounter. This ensures that the $70 expected reimbursement from insurance can be posted to a $70 balance in NextGen® Enterprise PM. Otherwise, a $70 reimbursement on an $80 balance would leave a balance.

• Payer Rounding: Exact units to the first decimal place

• Charge 1
  • CPT4 / Price: 90862 / $100.00 per unit
  • Base Minutes: 60
  • Start/Stop Times: 10:00 – 10:21 = 21 minutes
  • Quantity/Units: 0.4 unit
  • Charge Amount: 0.4 unit X $100.00 = $40.00

• Charge 2
  • CPT4 / Price: 90862 / $100.00 per unit
  • Base Minutes: 60
  • Start/Stop Times: 11:00 – 11:21 = 21 minutes
  • Quantity/Units: 0.4 unit
  • Charge Amount: 0.4 unit X $100.00 = $40.00

• Charge Totals: 90862; 0.8 unit; $80.00
• Roll-up Totals: 21 minutes + 21 minutes = 42 minutes = 0.7 unit
• Roll-up Claim: 90862; 0.7 unit; $70.00
• Variance: –0.1 unit X $100.00 = –$10.00