Implementation Date: 06/28/2013

Date of Last Revision: 08/11/2022

Next Review Due: 08/10/2025

Reviewed by VTH Administrative Team: 01/28/2015; 02/11/2015

Reviewed by VTH Board: 03/2013

Reviewed by Legal Counsel: N/A

Presented to VTH Section Heads: 06/26/2013; 02/12/2015

Subject to modification by the VTH Director without approval.

Printable PDF: VTH Adjustment Policy

Policy

Any adjustment to patient accounts shall be duly authorized and shall be made in full compliance with campus and hospital rules and regulations, as well as operational policies.

Guidelines

All charges for supplies, medications, procedures, etc. must be entered into the appropriate client’s account. Any adjustments should be applied to the account prior to discharge using one of the following approved adjustment procedures.

• Client services will set the expectation with our clients that charges may be added to the medical record within 10 days of service. This will allow for services to retrospectively enter charges from the weekend or overnight patient care. Charges entered after 10 days MUST be communicated to the client by the service and that communication documented in the EMR, with an indication of client consent when warranted.

NOTE: Charges or adjustments after discharge, and later than 10 days after service, may be charged against the Service account as determined by the Service Head or at the discretion of the VTH Director or business office designee.

Procedure (if applicable)

All adjustments should be made on a client’s account prior to discharge to prevent additional processing costs and the need to refund clients after they have paid their bill. The following adjustments are allowed:

1. Teaching Adjustments (includes necropsy adjustments)

1. To provide an opportunity for an extraordinary learning experience for DVM students beyond what would be part of the standard treatment or diagnosis for the patient to offset the cost of supplies used in student teaching. Funds are not for House Officers or Faculty use.
2. Approval may be made by either the Service/Section Head, VTH Director or business office designee.
3. Refer to VTH Policy VTH Teaching Adjustment and complete the online Teaching Adjustment Form (Necropsy Adjustments are exempt from the online adjustment form)

Process for submitting the online adjustment form for a teaching adjustment: 

1. https://appserv7.admin.uillinois.edu/FormBuilderSurvey/Survey/UIUCVetMed/admin/adjustme nt_form/
2. Log In using your net ID and password
3. Fill out form for current fiscal year 
4. Enter applicable client information – choose credit adjustment – provide reason for adjustment and dollar amount of adjustment to be processed – save – route the form to proper approver – submit – enter DBF code – save.

2. Discretionary Adjustments

1. To provide a mechanism by which an error made in the management of a clinical case/patient may be adjusted from the client’s bill and charged against the VTH Discretionary Account
2. Approval must be made by VTH Director or business office designee
3. Refer to VTH Policy VTH Discretionary Adjustment and complete the online Discretionary Adjustment Form.
4. A Release of All Claims form signed by the client will be required for discretionary adjustment requests over $500

   Process for submitting the online adjustment form for a discretionary adjustment:

1. https://appserv7.admin.uillinois.edu/FormBuilderSurvey/Survey/UIUCVetMed/admin/adjustment_form/
2. Log In using your net ID and password
3. Fill out the form for current fiscal year
4. Enter applicable client information – choose credit adjustment – provide a reason for the adjustment and dollar amount of adjustment to be processed – save – route the form to proper approver – save – enter an applicable reason for adjustment – save.

3. Research Accounts

1. Refer to VTH Policy Research Adjustment- Clinical Research and complete the online Research Adjustment Form
2. Approval must be made by the PI or designee on the account 

4. Program Adjustments are those made to Friends' Accounts or other Gift funds available to the service 

1. Approval must be made by the Service Head or VTH Director’s Office (or designee)
2. Complete the Funding Authorization Form here: VTH Gift Fund Application

5. Client Funding – These are funds set up through the UI Foundation (Advancement) and designated for the financial assistance of specific types of clinical cases.

1. Prior approval must be made by VTH Director or designee and is based on the criteria outlined in Client Funding Requests.
2. Complete the Funding Authorization Form here: VTH Gift Fund Application

6. Credit Adjustment – To remove an incorrect charge after patient discharge.

1. Approval must be made by the Service Head or designated service personnel.
2. Refer to VTH policy Client Account Credits and complete the online Credit Adjustment Form

Process for submitting the online adjustment form for a credit adjustment:

1. https://appserv7.admin.uillinois.edu/FormBuilderSurvey/Survey/UIUCVetMed/admin/adjustment_form/
2. Log In using your net ID and password
3. Fill out form for current fiscal year
4. Enter applicable client information – choose credit adjustment – provide a reason for the adjustment and dollar amount of adjustment to be processed – save – route the form to proper approver – save – enter an applicable reason for adjustment – save.

7. Administrative Adjustment

1. Charged against the VTH Discretionary Account to typically avoid billing an owner for small amounts discovered following a patient’s discharge or closing an account and in order to promote goodwill to clients and/or rDVMs.
   1. Review and decisions on these adjustments will be the responsibility of VTH Business Team and approval will be made by the VTH Director or business office designee.
      1. Amounts <$50 may be adjusted off without documentation.
2. Charged against the service revenue in instances where the service fails to enter charges appropriately. Clients understand that charges may be entered up to 10 days after discharge. Charges entered after that date are processed as an administrative adjustment against the service’s revenue.
   1. Review and decisions on these adjustments will be the responsibility of VTH Business Team and adjustments will be processed by the business office designee.
      1. All amounts may be adjusted off without documentation.
3. Charged against various service revenue in to reflect research discounts in accordance with Research Adjustment- Clinical Research & Research Adjustment – Veterinary Care of University Owned Animals.
   1. Review and decisions on these adjustments will be the responsibility of VTH Business Team and adjustments will be processed by the business office designee.
      1. All amounts may be adjusted off without documentation.
      2. Calculations are saved on the VTH Business Office shared drive for historical tracking purposes.

8. Medication and feed sale Adjustments – Online adjustment forms are not required for medication and feed sale-related adjustments. Contact the Medication Dispensary directly to adjust these charges.

Definitions (if applicable)

Adjustment – any deviation from the posted charges made to a VTH account/invoice. All adjustments are paid by moving some or all the charge(s) to another valid University account.

Credit Adjustment – A VTH member has determined that an expense has been assessed incorrectly to a client resulting in the need to adjust the client’s invoice and patient’s medical history.

Discretionary Adjustment – A faculty member has determined that a procedure had an unexpected or untoward outcome, or an error was made resulting in the need to adjust the client’s invoice.

Release of all Claims form – A form that discharges the University of Illinois from any further actions, claims, or alleged damages on the behalf of a client, if an adjustment is agreed upon.

Veterinary Teaching Hospital (VTH) – The collective clinical services of the Large Animal Clinic, Midwest Equine, the Small Animal Clinic, and the Veterinary Medicine South Clinic.