Credit Balance Refunds
Refrain from being non-compliant with Prudence RCM Solutions Credit Balance and Refunds Management Services. Returning the money collected in excess as compared to fees charged for medical services rendered is the responsibility of the healthcare provider. While credit balances could happen on account of a variety of reasons, the top reasons are an over-payment from the payers and patient payments.
Failure to refund credit balances promptly could result in heavy legal costs, fines, and imprisonment. Hence it is vital that a dedicated team of experts processes your credit balances each month to avoid such situations.
Credit balances could provide an incorrect view of the financial health of the providers, and hence timely processing can give you the right view of your financial health.
Often, healthcare providers have the same teams performing A/R Follow-up as well as credit balances, which drains productivity and creates a lack of focus.
Outsource your credit balance and refund processing to Prudence RCM Solutions to be assured of best-in-class service and avoid the risk of non-compliance. We have a Dedicated team who are experts in analyzing and processing credit balances.
Key Functions of Credit Balances:
Credit Balance with Payers.
There are various reasons when credit is created on account due to overpayment from the payers. Our team perform below steps in verifying and processing refund:
- Verification.We validate each refund requests, and if valid, process the refunds and reconcile the patient accounts.
- Disputes. . If we find a refund request to be invalid, we review the request again and file an appeal/dispute with the payers to avoid unnecessary refunds.
- Prioritization of Refunds to Government Payers. Refunds to Government payers should be processed within 60 days from the time of refund request date. Our team prioritizes the request from Government Payers and processes the requests promptly.
Patient Credit Balance
We validate each account with a credit balance and process refund checks to the patient promptly after verifying to ensure they are true credits to refund.