Description:
If an office receives an ERA 835 payment for a claim that has already been marked as closed, the funds are posted to the account awaiting allocation and they will allocate to the next available open claim if a patient has an open claim.
For example, a patient had an autopayment posted on 11/5. The ledger shows that the payment was for DOS 10/29. However, the EOB in Denticon shows the payment was actually for DOS 4/24. The claim for this DOS was already marked closed prior to the payment, the patient still had an open claim for DOS 10/29 for the same amount, so the payment allocated to the claim for DOS 10/29.
Best Practices:
To avoid this, if there is any potential for a corrected payment, the office should wait to close the claim or mark it as partially paid.