Has anyone dealt with insurance recoupments? If so, have you found a good way to handle posting it?
It is becoming more frequent in our office where an insurance company will adjudicate a claim and send payment, but then turn around and decide they want to downgrade a procedure so they just recoup the money from subsequent claims, even if it's on a different patient.
And before I start creating unnecessary Transaction Codes, I wanted to see if there was a "best practice" out there for making everything balance. This is the basic scenario:
I would like our Daysheet deposits to balance with what is actually in the bank ($84 and $20)?
Also, is there a code range to use so that the Claim #s can be properly linked and the payment on each claim reflects the total amount paid for each claim? So the total amount paid for Claim 1 is $0. And the total benefit amount for Claim 2 is $74.40, but $104 was paid, so the insurance will recoup $29.60 on a subsequent claim.
Any suggestions would be greatly appreciated!
We use an insurance refund code, posted as refund to insurance company. Our books balance at the end of the day. We do it similarly, when we refund a patient for overpayment, just with a different code.
We use code 33.10 (I am not sure of the range) and we do not typically attach it to a claim, we just make a note regarding the date of service and details in the note field. By that time, the claim would have already been closed. I also typically scan a copy into the patient documents for reference.