Insurance Recouped Payment

Remits that include recouped payments along with currently processed and paid claims require 'reversing' payment amounts within the claims manager in order to balance correctly. If payers simply request a refund, that process can be done within the patient's ledger using adjustment codes.

Complete the Remit information in Insurance Payment Posting. Check amount should be the actual amount of the check, and not the Payment Amount.

Select Patient by typing Claim/Account number on remit to open directly to the visit, or by searching for patient account using the Chart Rack. Opening account by patient name will require scrolling to locate the visit to which payment applies.

Remove payment made in error

1. Type the amount being recouped in the Provider Paid column for the selected visit. To make amount negative, type a dash (-) before the amount to be recouped. A negative amount will display in parentheses as shown in the screenshot. (Adjustments taken previously will need to be reversed as well)

2. Type the negative amount being recouped in Payment Amount.

3. To document reason for negative amount, or other details, click the drop down arrow in the Notes column, type your comment, and click OK.

4. Save Claim to continue.

Apply recouped amount

Note the recouped amount is added to the Remaining amount.

5. Type Account/Claim number to which the recouped amount will be applied, and Select.

6. Type payment amount.

7. Apply payment to line item(s) in Provider Paid column.

8. Select Next Action.

9 Same Claim.

Apply Remaining Payments

Apply Remaining Payments

10. Apply remaining transactions on remit, if applicable. This example remit has one more payment to apply, which is the actual amount of the check.

11. Apply remaining payments and adjustments.

12. Save Claim

Print/Save Payment

Selecting Print Payment will open the Remit Report print preview to either print or save report in several formats for later reference, if needed.

Post Payment

Post Payment

When Remaining amount is zero and Remit Report has been printed or saved, Post remit to patient's ledger. Payments will not be reflected on reporting or accounts until the remit is Posted.

View transaction in Ledger

Double click line item to view details.

Hover over payment to display payment details, and double click line item to drill down to further details and comments.

View Payment Summary

View Payment Summary

Payment Summary report will list details of transactions, but will only display the actual amount of payment made for this remit.