Wiki ERA Posting files/recoupments

[aleigh]

Is there anyone out there that is a master at ERA posting, understanding the remittances? The lady who trained the girl in our office did a not so great job, so I am trying to help her. Trying to figure out forwarding balance vs. recoupment. I have an example below..
To me that looks like they paid $131.07 on this check, but recouped $17.09 bringing the check total to $113.98. But she is being told that FB means they have not taken anything back, and will be forwarding this balance to take back on another check Very confused. Any help is appreciated.


TOTAL PAID TO PROVIDER : 131.07

TOTAL INTEREST AMOUNT : 0.00
TOTAL CHECK/EFT AMOUNT : 113.98

PROV ADJ CODE: FB FCN/OTHER IDENTIFIER: AMT: 17.09

 

[jmarjane]

Is there anyone out there that is a master at ERA posting, understanding the remittances? The lady who trained the girl in our office did a not so great job, so I am trying to help her. Trying to figure out forwarding balance vs. recoupment. I have an example below..
To me that looks like they paid $131.07 on this check, but recouped $17.09 bringing the check total to $113.98. But she is being told that FB means they have not taken anything back, and will be forwarding this balance to take back on another check Very confused. Any help is appreciated.


TOTAL PAID TO PROVIDER : 131.07

TOTAL INTEREST AMOUNT : 0.00
TOTAL CHECK/EFT AMOUNT : 113.98

PROV ADJ CODE: FB FCN/OTHER IDENTIFIER: AMT: 17.09

This link has helped me. Hope it finds you well!

https://www.noridianmedicare.com/provider/updates/docs/Explain_FB_WO_on_Medicare_RAs.pdf

 

[honeybee]

I have found it can depend on the payer, sometimes on our Medicare ERA's it will indicate a forwarding balance but you can tell there is no recoupment because the check amount is the same as the total remit balance. It appears that you have an actual recoupment given the balance of your total payment is less the amount of the forwarding balance listed.

Until you get more comfortable at identifying them you may also be able to cross check it by pulling a copy of the specific remit from the payer website to be sure (if available). We sometimes have to do this because our ERA will just indicate a claim number and we will have trouble fining that specific claim number if we had to undo the claim to say rebill it to a different ins carrier thus creating a new claim number. Sometimes I can go to the ins website and find that same check and see all the specific patient info to know where my offset needs to be taken from.

 

[aleigh]

Thank you both!

 

[dcsturgis@twcny.rr.com]

you can check the remittance; recoup from patient A with that money amount and then take that monies taken out of an account and transfer to patient B account which the insurance is paying on. the patient A (perhaps due to coverage termination; paid in error due to deductible or not covered in the plan; etc. That is how the ZERO balance becomes available by taking the monies out from account A to account B. Does that make sense?

 

[hebert@azaleaortho.com]

Is there anyone out there that is a master at ERA posting, understanding the remittances? The lady who trained the girl in our office did a not so great job, so I am trying to help her. Trying to figure out forwarding balance vs. recoupment. I have an example below..
To me that looks like they paid $131.07 on this check, but recouped $17.09 bringing the check total to $113.98. But she is being told that FB means they have not taken anything back, and will be forwarding this balance to take back on another check Very confused. Any help is appreciated.


TOTAL PAID TO PROVIDER : 131.07

TOTAL INTEREST AMOUNT : 0.00
TOTAL CHECK/EFT AMOUNT : 113.98

PROV ADJ CODE: FB FCN/OTHER IDENTIFIER: AMT: 17.09

On a Medicare Part B remit, the FB indicates a forwarding balance (usually a future recoup, therefore it's not actually taken from that check). When a recoup is actually on the check it will have a WO (indicating an overpayment recovery) next to it. Hope that helps