Billing
Adjustments
An adjustment reduces what is owed without anyone paying it. In ArkCloud adjustments are created by specific events - a payer's remittance, an approved financial-assistance discount, a bad-debt write-off - not typed onto an account freehand.
Written for: Billing and RCM teams · Finance
Where adjustments come from
| Field or control | What it means |
|---|---|
| Contractual (from the 835) | When a remittance is posted, an adjustment outside PR reduces the charge's balance only when its group is CO, PI or OA and its reason code is on the practice's write-off list (for example CO-45, charge over the fee schedule). Any other payer adjustment is recorded as a denial and stays in the balance for someone to work. Recorded per line with group and reason code. See remittance processing. |
| Financial-assistance discount | Approving a financial-assistance case with a discount amount adjusts the patient's charges and the account by that amount, once, capped at what the patient owes. Supervisor or Admin. See financial assistance. |
| Denied charge written off | Write off on a denial's detail page adjusts the denied amount off the charge. Supervisor or Admin. See denials. |
| Bad-debt write-off | No screen reaches this today (see bad debt). When it runs, it is written off as an adjustment, so the balance falls to zero (or to the remainder for a partial write-off) and the write-off appears in adjustment totals. See bad debt. |
Patient responsibility is not an adjustment
Deductible, coinsurance and copay (PR on the 835) do not reduce the balance. They record that the patient, not the payer, owes that part. Moving a claim to the patient works the same way: it changes who owes the money, not how much.