Forwarding Balance (FB) Vs. A Withhold (WO) - JF Part B
Forwarding Balance (FB) Vs. A Withhold (WO)
When a claim is adjusted, a remit will be sent to the provider informing them it has been reprocessed. The remit will have a Provider Level Balance (PLB) reason code FB. This adjustment does not represent a recoupment. Recoupments are identified with the PLB reason code WO. Clarification of the PLB reason codes FB and WO are below.
Forward Balance (FB)
A Forwarding Balance is not a recoupment. It is notifying the provider the claim has already paid previously. The claim may have previously paid more, less, or the same. The remit will display a 13-digit Financial Control Number (FCN) which will be the Internal Control Number (ICN) of the claim that was adjusted. Providers can refer to the ICN the Forwarding Balance is for and review the PREV PAID amount under the ICN. The PREV PAID is the amount the claim had previously paid and should be compared to the current paid amount. If the previous paid amount is more, then the net amount on the remit will be zero, and the provider owes Medicare the difference. If the previous paid amount is less, than Medicare is paying the provider the difference between the previous paid and current paid amount. Further assistance with locating these fields can be found in Noridian’s Remittance Advice Tutorial.
Withhold (WO)
A withholding is money being withheld (recouped) from a remit to satisfy an outstanding debt the provider owes Medicare. Providers can verify which patient a withholding is for by using the Noridian Medicare Portal (NMP). By removing the first two digits of the 15-digit FCN, providers can use the FCN as the ICN on NMP’s Remittance Advice function to look up a claim specific remittance.
Note: A withholding is a payment subtraction at the tax identification level. Medicare does not hold payments from one patient to apply them to another. While Noridian can instruct providers what patients they owed money for, Noridian cannot instruct providers what accounts to apply these withholdings to. These questions need to be addressed with an accountant.
