Create an EDI Adjustment File to Submit to PROMISe

Instead of manually adjusting claims one-by-one in PROMISe due to a rate change, needs level, etc., you can now create an EDI Adjustment file to submit to PROMISe to process all the adjustments for an entire facility/multiple facilities.  It is important to follow the Horizon Recommended Billing Process.  

The EDI adjustment file process will not work if you are not following the billing steps – specifically the steps listed below.  If you are not completing any of these steps, please contact Horizon Help Desk before proceeding.

  1. Service Billed through the system
  2. Service Paid by PROMISe – approved for payment
  3. Trade File Imported – has ICN number needed for this process
  4. Create AR Process Completed 

Correct Rates

  1. Utilities menu > Rebuild Processes > Rebuild Rates
  2. Update facility master

Roll Back Service

NAVIGATION: ANALYSIS menu > Service Maintenance

  1. Select consumer, dates, facility, service code – click the REBUILD button.
  2. Find the entry you need to adjust.
  3. Place a check in the box at the beginning of the line; click the ROLL BACK SERVICE button.

Select Services to Adjust

NAVIGATION: Billing/AR menu > Adjustment Processing > Service Adjustment Selection

  1. Adjustments can be made for an entire facility by selecting the facility/leaving case number blank.  
  2. Run this process several times to adjust multiple facilities.
  3. Run the report to view the all the services that are able to be adjusted (based on the steps already completed above).
    1. Enter the date range/case number/facility/service selections.
    2. Leave the checkbox “By checking this box, the adjustment record will be created” unchecked.
    3. Click the RUN PROCESS button.
  4. Mark the claim/services so they are flagged to be added to the adjustment file
    1. Once you have reviewed the adjustment report, go back to the Service Adjustment Selection screen.
    2. Enter the date range/case number/facility/service selections.
    3. Check the box “By checking this box, the adjustment record will be created” unchecked.
    4. Click the RUN PROCESS button.

Review EDI Adjustment Edit List

NAVIGATION: Billing/AR menu > Adjustment Processing > EDI Adjustment Edit List

  1. Enter the selections.  Select all the facilities you want to adjust.
  2. Click the RUN PROCESS button.
  3. This is the same as the normal billing process; review make sure the EDI file amount matches the service adjustment selection amount.


Create EDI Adjustment File

NAVIGATION: Billing/AR menu > Adjustment Processing > EDI Adjustment Process

  1. Enter the selections.  Select all the facilities you want to adjust.
  2. Click the CREATE BILLING button.
  3. The EDI adjustment file will display in the grid when complete or you can pull from the dashboard.  Download the file/save to your computer.
  4. Submit the file to EDIaaS
  5. This is the same as the normal billing process.  Verify the EDI file amount matches the service adjustment selection amount.

Review EDI Billing Verification

NAVIGATION: Billing/AR menu > EDI Billing Verification

Complete the Billing Process

  1. Follow the Recommended Billing Process
  2. The next time you create AR, it will update the invoice/AR with the new adjustment amount.

2/2026

NEED MORE HELP?  Submit a ticket to the Help Desk or call (814) 535-7810 or (800) 889-3388