At a Glance
Payers will sometimes overpay for an encounter and leave you wondering what to do with the negative balance. This guide details your options in this situation.
The short version:
Money cannot be repaid to payers through Insights.
For repayments, you can either wait for the payer to recoup their overpayment, or you can manually send money back outside of Insights and then make adjustments to encounters to reflect the new balance in Insights.
This guide is for insurance overpayments and recoupments only. For information on PR overpayments, see the PR Overpayment Refunds guide.
Overview
When it comes to insurance overpayments, the good news is that in most cases, no action is required. The payer will automatically recoup their money within their own time frame (often within 30 days), send a different payment for the new amount if appropriate, and the encounter will update in Insights to reflect the corrected payment.
The less good news is that sometimes they’ll send a long letter with some devious language about charging interest on the overpayment if you don’t manually return it before they claw it back.
❓What’s the Difference Between Overpaid and Overposted?
- Overpaid
- Insurance paid more than was required.
- Overposted
- Multiple remittances have been sent for a single procedure which, combined, exceed the charge for a procedure.
- What can I do about overposted encounters?
- The Posting Tool can help you post the correct remittance and negate or archive the incorrect remittance.
🔍 How to Locate Overposted Encounters
Visit the Claim Details page and filter by Encounter Stage Reason > Overposted so you can quickly find all overposted encounters.
There is currently no equivalent filter to find overpaid encounters.
🧑🚒 How and When to Take Action
As mentioned previously, it is common for no action to be required for overpayments. The insurance company will claw back the overpayment automatically within their own time frame and Insights will reflect as much.
However…
Sometimes the payer will include sneaky language to take more money than what they are owed.
In this example, the payer will opt not to recoup the funds until more than 30 days have passed, and then charge a full month of interest before doing so.
This is, of course, a waste of money for your practice.
In this kind of situation, the best course of action would be to send the overpaid amount back to the payer outside of Insights, then update Insights manually to reflect the new information.
The guide below details the actions you can take using the Posting Tool page to make sure information is correctly updated in Insights:
You can access the Posting Tool for a specific claim directly from that claim’s ‘Actions’ menu.
Refer to your specific letter for rebuttal, appeal, repayment, and all other instructions.
Money cannot be repaid to payers within Insights.
In this example, the payer requests a check mailed to the given address.
In Conclusion
Read all letters from payers regarding overpayments very carefully before deciding on a course of action. They will tell you what processes and procedures are required to remedy the situation. You will only need to update Insights yourself if you choose to send money back to the payer externally before they recoup their payment.
📢 Further Assistance
We’re here to help! Please get in touch with support@getathelas.com if you’d like some hands-on assistance.
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