Wiki payment posting

[FABBOTT]

Hi there,

So, the employee who normally posts payments no longer works for my company, and I've been asked to post payments. My question is, when benefits are verified, and the insurance company indicates a copay for the patient, the patient pays it, then when posting the EOB, the insurance company pays the complete allowed amount. Should I adjust the contractual amounts or have each patient have a credit on their account? Thanks in advance.

 

[csperoni]

If the EOB indicates the patient responsibility is less than what was collected, the patient is due a refund of their overpayment. Sometimes the patient met their out of pocket max, or you did an in office procedure that the insurance does not apply a copay to.
It is acceptable if the patient has an upcoming service, to leave the credit to apply to next visit, but it is not OK to just leave credits on accounts indefinitely and not refund the patient. If it's a large company, there should already be some department doing this, or policy in place. Smaller offices may just do on a case by case basis.