Medical Billing Forum
General Category => General Questions => : margemib December 22, 2009, 12:06:00 PM
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Michele,
what do you do if the carrier or patient over paid and has a refund coming from the provider, what steps do you take to insure the refunds will be made?
margemib
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I notify the provider of the overpayment, and that the money should be returned. I note it on my end (that I notified "person's name from provider's office" on December 23, 2009 that patient had an overpayment of xx dollars). What the provider does from that point is out of my hands. Most of the ones I work with I have no doubt take care of it. I don't like to work with the ones that don't. Some will just inform the patient and let them take it as a credit on future balances, but it's the patient's choice.
Michele
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That sounds smart, how do you justify this balance in you software.
margemib
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i adjust mines off as an overpayment. I don't keep that in my system since I have NOTHING to do with that end of it. As michelle stated once u tell the provider and document it. you are done.
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If I don't do patient billing, I adjust it off too. But if I do their patient billing, and it's a provider who has repeat visits (mental health, chiro, etc) I ask the provider if they are refunding to the patient, or applying to future visits. If they are applying to future visits I adjust it out of the billing it is overpaid on (with a note as to what I'm doing) and apply the credit to the future billings.
Michele
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Thanks for the advice,
Have a Happy Hoilday to everyone!
margemib ::)
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I don't adjust it off unless I am getting documentation that it was refunded or that it should be adjusted off and I require it in writing. The reason is that if you do adjust it off, the accounts are NOT accurate in reports. The doctors then don't get to see these overpayment sitting there and don't have the need to act on them. If I have a provider who has a significant refund they have to send out, I not only inform them in writing of the amount but the reason and the implications of what happens if they don't refund it, this way there is no element of surprise. I also require them to sign off on it and initial that they have read my recommendation. Again, I think it's important that reports reflect accurate data and won't adjust anything off without directive to do so.