What should a practice auto-write-off? A defensible policy.
A defensible write-off policy distinguishes adjustments you must take (contractual write-offs under your payer agreements) from balances you choose to abandon (small denials not worth working) — and it sets the second by an explicit dollar-and-effort threshold, not by whoever's too busy. The danger is a threshold set for manual labor cost: it writes off winnable money simply because chasing it by hand costs too much.
What actually matters
- Separate contractual adjustments (required, e.g. CO-45) from true write-offs (a business choice to stop pursuing a balance)
- Set an explicit small-balance threshold with sign-off — not an implicit "we didn't get to it"
- Never auto-write-off by denial reason alone; a $40 and a $4,000 claim can carry the same CARC
- Revisit the threshold when the cost to work a claim drops — money that wasn't worth chasing by hand may be worth recovering now
- Track what you write off; a growing write-off pile is a signal, not just an accounting entry
Common questions
What's the difference between a contractual adjustment and a write-off?
A contractual adjustment is the amount you agreed to accept below your charge under a payer contract — required, not optional. A write-off is a decision to stop pursuing a balance you could still collect. Blurring the two hides recoverable money inside "adjustments."
Is it okay to auto-write-off small denials?
Only with an explicit, reviewed threshold — and only because working them by hand costs more than they return, not because they're unwinnable. When the cost to work them falls, that same pile is worth revisiting.
Where Volari fits: The small-denial write-off threshold exists because manual appeals cost too much — Volari lowers that cost, which is why claims below your threshold become worth recovering.
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