What is the recommendation by X12 on how to report a reduction in prior PLB FB balance when the monetary amount is being reduced by: 1) Bad Debt - The payer determines to write off amount owed by the provider, and 2) Legal Settlement - legal agreement between payer and provider that identifies the amount of the reduction in the balance due. In both situations what would be the appropriate PLB Adjustment reason code and Reference Id utilized to indicate a reduction in the PLB FB balance due?
The PLB adjustment code BD (Bad Debt Adjustment) would be used for bad debt, and code PL (Payment Final - with a note reading "This is the final settlement") would be used for legal settlement.
The reference identification element for the bad debt situation should include a value relevant to the amount or specific claim that is bring written off that has been communicated from the payer to the provider via letter or other method of communication. The reference identification element for the legal settlement situation should include a value relevant to the the legal action that has been communicated from the payer to the provider via letter or other method of communication.