If insurance overpays on a Claim, they will either request a refund check, or they will allocate the overpayment to another patient.
Refund via check
- In the Account Module, double-click on the claim.
- Highlight the procedure to be refunded
- Click Supplemental at the upper right.
- Enter the refund amount as a negative amount for Ins Pay (e.g. -10), then click OK.
- In the Claim, click This Claim Only.
- Enter any needed check information and enter the payment amount as a negative (e.g. -10).
- Complete the rest of the payment as normal. See Finalize Insurance Payment.
- Offices may wish to create a new Insurance Payment Type for Insurance Refund checks to avoid incorrect totals if using Deposit Slips.
- If a payment is being refunded due to eligibilty, additional supplemental payments may be needed to adjust off write-offs as well.
This will correct the patient account balance making the patient responsible for the previous overpayment. If the office does not want the patient to be responsible for the balance, enter a negative Adjustment to subtract the amount from the account balance.
Allocate to a different claim
There are times when instead of having an office send a refund check back to the carrier, the carrier will instead deduct the overpayment from another claim. This may be on a future claim from the same patient or an entirely different patient, but the process is still the same. The office will enter in a negative supplemental payment into the overpaid claim (as described above), but instead of finalizing a negative payment, the payment will be batched together with a positive payment.
- Double-click the claim that was overpaid and needs to be refunded.
- Follow steps 2-4 from Refund via Check above to enter the overpayment as a negative payment.
- Create a Batch Insurance check from the Manage Module using the Batch Ins button.
- Attach the refunded claim to the bulk payment.
- Receive all other claims on the EOB and attach them to the payment. (See:Batch Insurance Payment for detailed instructions.)
- Once all claims on the EOB are received, the total payments of the attached claims should match the amount of the payment. The payment is already finalized.