Resolve Credit Discrepancies Quickly
When payers reimburse more than what was charged, patients pay more than what was quoted, or incorrect charge edits were made in the billing system, credit balances result in an overstated accounts receivables. If credit from overpaid claims are not refunded in a timely manner, providers could face penalties or risk alleged misappropriation of funds claims.
We help healthcare providers overcome their credit balance challenges by assigning one or more of our skilled billing specialists to their project to reduce credit balance volumes in their accounts receivable and process the required refunds.
Our team springs to action as soon as credit balances when:
- payer reimbursed more than what was charged
- patient paid more than quoted
- duplicate payment by payer and patient, or primary and secondary payer
- payments were not posted correctly
HOW WE DO IT
Powered By Technology & Our Billing Specialists
Optimized by our automations and proprietary intelligent workforce management technology, our experienced billing specialists are able to complete credit balance resolution activities within 24 to 48 hours after the overpayment is detected.
- Review patient records of accounts showing credit
- EOBs and ERAs are compared against credit discrepancies
- Overpayment sources are identified (patient or payer)
- Incorrect transactions are reversed and reposted
- Transfers of overpayments to open balances
- Confirmation of payer versus patient refunds
- Refund letter and payment records are consolidated and formatted into refund file packets
DRIVE PERFORMANCE IMPROVEMENTS
Get Visibility Into Our Workflow
Our proprietary analytics tool provides real-time status of all outstanding credit balance like posting errors, charge corrections, payments received and final resolutions. Custom reports can be created based on your unique needs.
We also help our clients with end-of-month deadlines. We usually close EOM by the first business day of the following month. Regular audits are performed to avoid month-end delays.
Root Cause Analysis
We help identifying root causes and credit balance trends to advise on process improvements to activities that are causing credit balances. With our real-time reports, you can see where issues arise so your team can avoid them in the future.