Insurance reversed payment 6 months after the procedures

For users or potential users.

Insurance reversed payment 6 months after the procedures

Postby ForrestGumpDDS » Tue Jun 11, 2019 8:10 am

Good morning.
Sorry if it's been asked before, can't seem to find the answer right away.
Pt. had a services done Dec 2018. A crown and filling w. xray, 2 claims.
Insurance paid 1 months later. We mark the claims received, created 2 payments - Billed amount, minus w/o, applied percentage, indicated patient portion. The pt. paid the portion. Nothing extraordinary.
Today, 6 months later, my FD is getting a letter from the insurance company, stating that the member had had a coverage terminated 1 month prior to the date of service, November 2018.
All the billing entries are locked at this point.
We need to introduce the entries addressing:
  1. reversal of the payment linked somehow to the claim
  2. refund check to the insurance, possibly the same thing as item #1
  3. removing of the write off
  4. Patient balance should now show the amount as if the pt. had it done w/o any insurance, UCR fees. We can then work with the pt. offering either "prepayment discount' or payment plan.
How do we do it considering the ledger entries are locked (for the FD, not for me, but I want them be able to handle the task like that).
Thank you
ForrestGumpDDS
 
Posts: 163
Joined: Fri Oct 14, 2011 3:31 pm

Re: Insurance reversed payment 6 months after the procedures

Postby speeples » Wed Jun 19, 2019 7:14 am

I have had to do this and I called OD. They were great walking me through it....twice ;) It would be so much better to talk to someone than me try to type it out LoL
speeples
 
Posts: 9
Joined: Tue Feb 05, 2019 1:27 pm

Re: Insurance reversed payment 6 months after the procedures

Postby Manny Ramirez » Tue Jun 25, 2019 6:22 pm

Can you enter a negative adjustment (Insurance Reimbursement) into the Patient's account?
Manny Ramirez
Senior Network Engineer
E-ssential Networks LLC
User avatar
Manny Ramirez
 
Posts: 129
Joined: Tue Mar 06, 2012 4:07 pm
Location: Miami/Puerto Rico


Return to Main Forum

Who is online

Users browsing this forum: No registered users and 11 guests