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Premolar I

Insurance Recoupments

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: 

PatientLedger.png

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!

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Premolar I

Re: Insurance Recoupments

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. 

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Premolar I

Re: Insurance Recoupments

@enspire: What codes (or code ranges) do you use for those refunds? And can you attach the claim # to them?
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Premolar I

Re: Insurance Recoupments

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.  

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