Category: RFR

You may refund undistributed amounts to any payer.

Start by checking to see if the amount you want to refund is available in the system as undistributed funds — that is, funds that have not been distributed to specific patient accounts in the form of a credit entry and have not been applied to any specific charges. If the amount that you want to refund has already been applied, you can reverse the payment to convert the amount to undistributed, making it refundable. See How to Reverse a Credit Entry, Bounced Check, or Over-Payment for the details.

1. In the Navigation Bar on the left side of the screen, click the type of payer (Insurance Carrier, Private Payer, or Patient (Self) Payer) you want to review. Look for non-zero amounts in the Total Undistributed Amount column. (Tip: Use the filter row just beneath the Undistributed column heading to change the column filter to “>”, then and type in a zero. Remember to clear the filter when you are done, using the same drop list.)

   

   

   
   

2. When you find the desired payer in the appropriate Payer list, confirm that the undistributed amount is at least as much as you intend to refund.

   

3. Open the Payer by double-clicking or by selecting the row and clicking the Edit (pencil) button on the tool bar.
4. Now look through the various Voucher tabs to locate the undistributed amount(s) that you want to refund.

   

5. To do the refund, open the detail view (Edit) the Voucher, and select the Refunds tab in the list box at the bottom.

   

6. Click the New button to record the amount to be refunded and the date, then save and exit on this screen as well as on the Voucher.

   

7. Notice that the undistributed amount on the Voucher and the Payer will now be reduced by the amount of your refund.

• Start by checking to see if the amount you want to refund is available in the system as undistributed funds — that is, funds that have not been distributed to specific patient accounts in the form of a credit entry and have not been applied to any specific charges.
  • In the Navigation Bar on the left side of the screen, click the type of payer (Insurance Carrier, Private Payer, or Patient (Self) Payer) you want to review. Look for non-zero amounts in the Undistributed column. (Tip: Use the filter row just beneath the Undistributed column heading to change the column filter to “>”, then and type in a zero. Remember to clear the filter when you are done.)

Both insurance payers and non-insurance payers may be shared among two or more patient accounts. In fact, when it comes to insurance payers, that is the typical situation. The same large insurance payer, such as Medicare or United Healthcare, may well appear on the payer lists of many of your patients. Likewise, you might create a non-insurance payer for one of the parents in a family in which several family members, each with their own SOS account, are receiving treatment. Yet another example would be a forensic practice that receives payment from a law firm for several different client accounts.

When payments are received from one of these multi-patient payers, the payment can be attributed to one or more of the patient accounts that list that payer. There are several reasons why you might want to move a payment, or part of a payment, that was credited to one account to a different account:

• There might have been a clerical error in which an amount was credited to the wrong account.
• An insurance payer might issue a “take back”, in which an amount paid originally is reduced, and you are instructed to apply the difference to a service rendered to a different account.
• A prepaid amount will not be needed on one account and the payer has requested that it be applied to a different account.

If you want to understand the procedure for moving payments from one patient account to another, you must first understand the difference between undistributed payments, unapplied payments, and applied payments. If you are fuzzy on the distinction, please review the article entitled What is the Difference Between Unapplied and Undistributed Payments? In general, moving the payment requires that you convert an applied or unapplied payment on the first patient’s credit back to an undistributed payment for the payer. Once the payment status is reverted to undistributed, it can be used as a credit for any other patient linked to the payer.  Remember that in each of these scenarios, it is essential that both patient accounts share the same payer.

If the amount to be moved is unapplied…

If the amount to be moved is available as an unapplied payment in a credit entry for Patient One, then:

1. Open a Patient One credit that has an unapplied amount. That is, the credit amount is more than the total of what has been applied to charges in the credit splits.
2. Confirm that the unapplied amount matches or is greater than the amount you want to move to Patient Two.
3. Reduce the amount of the credit entry by the amount you want to move, but the new Credit Amount must be the same or more than the amount applied in the credit splits. If you make the credit amount too low, the Amount Unapplied will show a negative amount and you won’t be able to save the modified credit entry.
   
4. Note the description of the voucher, for example, the check number of the payment.
5. Save the credit. As the credit with its new, lower amount is saved, the unapplied payment amount on the Patient One credit will be reduced or eliminated and the undistributed amount of the payer’s voucher will increase by the same amount.
6. Now create a new credit entry for Patient Two.
7. Select the voucher noted in step 4 above as the payment source and adjust the amount of the credit as desired. It can be any amount up to the available undistributed amount available on the voucher.
8. Apply the payment to Patient Two services or simply save the amount as an unapplied payment for Patient Two.

If the amount to be moved is already applied…

If the amount you want to move is more than the unapplied amount of the credit, or there isn’t any unapplied amount, then you must reduce the amounts of one or more credit splits you have already applied to services in order to proceed:

1. Double-click one of the Credit Splits appearing in the list box at the bottom of the Credit Entry form. This list sits BELOW the Charge Splits list.
2. Double-click a credit split you would like to reduce, change the amount, and save. Do the same for other credit splits if appropriate.
3. As you save the change to each credit split and return to the Credit window, you will notice that the Amount Unapplied will increase by the same amount.
4. Now decrease the Credit Amount by that amount. When you save changes you have made to the credit, the payer’s payment voucher (in this example, the voucher for check number 54325432543) will reflect that the amount is now undistributed.
5. You can now enter a new credit for Patient Two, selecting the payer’s check number 54325432543 as the payment source.