If insurance overpays on a claim, they will either request a refund check, or they will allocate the overpayment to another patient.
If insurance is requesting the refund via check:
- In the Account Module, double click on the claim.
- Highlight the involved procedures, then 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.
This will correct the patient account balance making the patient responsible for the previous overpayment. If you do not want the patient to be responsible for the amount, enter a negative adjustment to subtract the amount from the account balance (Adjustment).
If insurance deducts the refund amount from a different claim payment (e.g. a different patient's payment) handle it as follows:
- Go into patient A's account (the patient the refund is being allocated to).
- Double click on the claim and receive using the information provided on the EOB. See Receive Claim.
- Go into patient B's account (the patient who was originally given the overpayment) and follow steps 1-3 above.
- Once all claims on the EOB are received, finalize the payment as usual. See Finalizing Insurance Payments.