Refunds

1. Refunds Chapter 29

2. Objective • Refund overpayments and duplicate payments

3. Key Concepts • Refunds to payers • Duplicate payments • Overpayments • Refunding all of a payment • Refunding a portion of a payment • Unapplied payments • Unidentified payments • Refunding on a line item • Refund batches • Closing a refund batch • Refund check process

4. Refund Processing • Sometimes payers (insurance companies. Employers, patients, guarantors) pay money to a facility in error • In these situations the facility refund the payer for all or portion of payment(s) • Duplicate payments • Paying more than is owed • Paying the wrong medical facility • Paying for services for which another payer already paid

5. 2 Types of Refund Situations • 1. Refunding all or part of a payment when there is no invoice to which to apply the money(unapplied) payment) • 2. Refunding overpayments on line items with an invoice

6. Basic Workflow Steps in Refunding a Payer • 1. The payment entry staff member creates an open refund batch to collect the refund info • 2. ….identifies that a payer should receive a refund • 3. ….records the amount of the refund • 4. ….records who should receive the refund check • 5. ….collect the refunds for a certain period of time into a batch • 6. ….send the refund requests to accounts payable • 7. ….writes refund checks and mails them • 8. ….sends copies of checks with refund requests back to payment entry staff • 9. ….records refund check info in refund records • 10. ...once all of the refund request records have refund check info recorded, the refund batch automatically closes

7. Payment Batches • Payment Batches screen showing all balances-Figure 29-1 • Do This! Pg. 368 • To add a new batch of payments click Add button Payment Batch; Add screen appears-Figure 29-2 • Do This! Pg. 369 • Add screen for adding individual payments-Figure 29-3 • Entity/Payers: Select screen-Figure 29-4 • Do This! Pg. 371 • Payment Posting screen-Figure 29-5 • Payment Posting Screen showing payment information recorded-Figure 29-6 • Invoices Applied by Payment screen displaying invoices paid by this payment-Figure 29-7 • Do This! Pg. 374

8. Payment Batches • Payment: Add screen for patient payment-Figure 29-8 • Patient Select screen for patient-Figure 29-9 • Do This! Pg. 376 • Payment Posting screen for patient payment-Figure 29-10 • Payment Posting screen after posting patient payment-Figure 29-11 • Do This! Pg. 378 • Batch Payments screen for refunded payments-Figure 29-12 • Do This! Pg. 379

9. Creating A Refund Batch • Billing Menu-Figure 29-13 • Refund Batches screen-Figure 29-14 • Refund Batch: Add screen for patient refunds-Figure 29-15 • Refund Batches screen showing patient batch record-Figure 29-16 • Do This! Pg. 382

10. Refunding Unapplied Payments(Or Unidentified Payments) • Billing Menu-Figure 29-17 • Accounts Receivable Aging Dashboard with unapplied payments-Figure 29-18 • Payments by Balance screen showing Nationwide-Figure 29-19 • Private Insurance Payments screen showing Nationwide-Figure 29-20 • Do This! Pg. 385 • Refund screen for Nationwide payment with no data-Figure 29-21 • Refund Codes screen-Figure 29-22 • Refund screen for Nationwide payment showing data-Figure 29-23 • Refund Detail screen for Nationwide refund-Figure 29-24 • Accounts Receivable Aging Dashboard with no unapplied payments-Figure 29-25 • Do This! Pg. 389

11. Refunding An Overpayment Of A Line Item • Accounts Receivable Aging Dashboard showing the drop-down list for Activity-Figure 29-26 • Accounts Receivable Aging Dashboard reset to overpaid invoices-Figure 29-27 • Invoices, Overpaid, Credit AR screen showing Nationwide invoice-Figure 29-28 • Payments Applied On Invoice screen for patient invoice-Figure 29-29 • Payment Posting screen for second patient payment-Figure 29-30 • Adjustment Codes screen showing refund codes-Figure 29-31 • Payment Posting screen showing refund data input-Figure 29-32 • Payment posting screen showing refund data processed-Figure 29-33 • Payments Applied on Invoice screen showing patient refund-Figure 29-34 • Do This! Pg. 397

12. Submitting A Refund Batch To Accounts Payable For Payment • Refund Batches screen showing patient refund-Figure 29-35 • Refund Master screen showing patient invoice refunds-Figure 29-36 • Refund detail screen for Nationwide refund-Figure 29-37 • Refund detail screen for patient refund-Figure 29-38 • Refund Master screen for patient refunds-Figure 29-39 • Refund Batches screen showing patient refunds-Figure 29-40 • Refund Batches screen showing patient batch submitted-Figure 29-41 • Do This! Pg. 402

13. After Accounts Payable Writes The Refund Checks • Refund screen for Nationwide showing the refund check data-Figure 29-42 • Refund Master screen showing Nationwide refund not pending-Figure 29-43 • Refund screen showing the patient refund check data-Figure 29-44 • Refund Master screen showing both refunds not pending-Figure 29-45 • Refund Batches screen showing a balance of zero-Figure 29-46 • Do This! Pg. 407

14. Printing The Refund Batch Print • You will need to print the refund to turn in for your assignment • Do This! Pg. 407