> ## Documentation Index
> Fetch the complete documentation index at: https://support.effra.io/llms.txt
> Use this file to discover all available pages before exploring further.

# What do I do if the insurer adjusts the invoice amount?

Sometimes insurers will adjust the invoice amount and then assess the claim.
The most common adjustment is changing an initial consultation to a follow-up.

When this happens, Effra will mark the invoice as `Insurer Shortfall` and include
a message explaining that the insurer has adjusted the invoice amount.

What you do next depends on whether you agree with the insurer's adjustment.

## If you agree with the adjustment

You should update the invoice amount in your practice management system (PMS) to the new amount.
You should then use the the `Sync` button on the Effra invoice page to update the invoice in Effra.

## If you disagree with the adjustment

You should [contact the insurer](../docs/insurer-contact-details) to challenge the adjustment.