Posting Logic for Bundled Payment to Multiple Charges

When you bill individual unit charge lines for the same CPT® code and the payer sends a single payment for all of those charges in the Electronic Remittance Advice (ERA) file, you can use the Post Bundled Payment to Multiple Charges option to distribute the transaction amounts. Based on the quantity, the Allowed, Payment, and Adjustment amounts are distributed equally across all charge lines. If the bundled transaction amount does not divide equally across the charge lines, the transaction is not posted and a message appears stating that the bundled payment did not get distributed equally Bundled Payment does not distribute equally in the ERA Import report.

The patient-responsible amounts (PR1 Deductible, PR2 Co-Insurance, PR3 Co-pay) are distributed for only reporting purposes and Cordination of Benefits (COB) balancing. The patient-responsible amounts are distributed using weighted distribution logic.

When you configure the Remittance Profile library to Only when deductible (PR1) exists in the Post zero line item payments option, the PR1 amount is distributed for only reporting and COB balancing. The PR1 amount is distributed using weighted logic to all the billed line items based on the number of units.