Insurance Recoupment

Insurance Recoupment

 A Recoupment is when insurance has overpaid on a date of service and they are asking you to move payment to another date of service they owe you for.

An Example would be where the insurance payer sent two EOBs that contain payment for the same date of service resulting in a credit for that line item. Instead of asking for a refund, they are asking you to apply the money to another outstanding charge within the clinic. This could be for a outstanding charge within the same patients ledger or a different patient entirely.

It is VERY important that when you are doing a Recoupment, you are not editing the original EOB that resulted in an over-payment of the charge.

The Recoupment process is done in two parts:

Part One – Recouping the Money

1.  Select "Post New EOB" and add in all info as normal, but leave the check amount blank since you are not posting any NEW money, you are moving existing money.

If the insurance company is requesting a recoupment on an EOB where payment was provided, ONLY enter the amount of the physical check received.

2.  Select “Next”.

3.  You will notice the amount across the top is $0.00 or the amount of the check provided.

4.  Select the patient’s name that the amount is being recouped from, click “Next”

5.  Select the date of service the money is being recouped from and select “Apply Date Filters”

6.  Once the filter is applied, select the green pencil to the far right of the charge.

 

7.  Adjust the responsibility of the charge if needed.  For example, if the responsibility is on the payer side it may need to be moved to the insurance side.

8.  Add the recoupment amount into the recoupment space provided and click “OK”.

 

9.  Click OK. Now you will see that the AMOUNT REMAINING area has changed to the recoupment total or the Check amount plus Recoupment total.

10.  Click “next”.

 11. Now you will click “Next” and then follow the steps below to finish by completing Part Two.

Part Two – Re-allocating the Funds

The second part to doing a recoupment is to take the money that was recouped from a patient and reallocate it to another patient as requested by the insurance company.  Keep in mind, when you begin the process to post the new EOB, you should NOT add the recoupment amount to the amount on the check.  The check amount entered into your software should match the actual amount that is on the check.

1.  Select the patient’s name the recouped money should be applied to.

2.  Select the date of service the money is to be applied. Click “Apply Date Filters”.

3.  Add the payment as you normally would post an insurance payment.  Once the payment has been added, you will see the money in the “Amount Remaining” field has been moved to the “Amount Applied”.

4.  Click “Next” and Complete the EOB.

5. Lastly, click “Yes” when it asks you if you are sure you want to complete the EOB.

- Support Information -

 If you have any questions or need assistance with this process please contact Support by:

Live chat: Click the 'Support Portal' button in your main toolbar (on left-hand side), click the green 'Support' box in bottom right of screen.***This has the fastest response time***

Phone: [phone]

Email: [e-mail]