11

Create a Pend / Denial Specific Adjustment

11.1

Search the desired claimants from any specific sub tab (Claimants, Claim Log, Notification Log, or Reserves).

11.2

Click the desired claimant from the list.

11.3

Click the Claims button.

11.4

Select the desired submission from the drop-down.

11.5

Click the Denied / Pended sub tab then click New to display the Specific Adjustment window.

11.6

Document the adjustment as follows

Adjustment Type
Check the box next to the type of adjustment you are making.

Note: If you check Pend, the reserve increases by what you put in the Amount field. However, releasing the pend will not release the reserves by the pend amount. Reserves are only released when payment is made and only for the amount of the payment. This means if you create a pend specific adjustment for an amount greater than the claim payment, your reserve will retain any amount over the payment.

Amount
Enter the adjustment amount here.
Description
Select the appropriate adjustment description from the drop-down. Adjustment descriptions are defined by your ESL Office administrator.
Comment
Provide any additional comments regarding the adjustment here.
11.7

Click Save & New if you want to create additional adjustments. Click Save if you are finished creating adjustments.