REFUNDS PROCESSING

PROCESSING VOID AND STALE DATED PATIENT AND INSURANCE REFUNDS.

Who wouldn’t want to have a credit balance on their books? However, a Credit Balance for the Healthcare provider can pose serious risks and become a liability if not managed well. Why so?

We deal with Credit Balances expeditiously when it comes to deciphering, processing and posting refunds or making account corrections, which is the key to protect revenue cycle integrity. A Credit Balance is not ‘extra cash’ or an asset for the healthcare provider. It means that you actually lit the fuse and it can go off anytime damaging your reputation and corroding goodwill if not managed through an effective A/R process.

It is the fiduciary responsibility of the provider to manage this risk. Almost 55% of credit balances are due to incorrect postings as per data available on the industry. Misuse of debit codes, wrong adjustments and credits that are processed erroneously are quite challenging to clear. QWay establishes a strong working relationship with clients in order to process their credit balances in a timely fashion and reduce the backlog.

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The team at QWay is comprised of professionals who have strong analytical skills with experience in hospital accounting standards and norms. Our cohesive working model with clients, and internal processes enables in resolving a higher number of credit balances as an ‘account correction’ instead of a refund. A successful Credit Balance process lies in its effectiveness to prevent it.

 

What we do at QWay to reduce and resolve Credit Balances?

  • Complete analysis of the account along with the EOB
  • Inspect patient liability and other issues on adjustment
  • Check to see if a double payment was made and if so refund
  • Check if there are two Insurance carriers and both are acting as primary
  • Work towards increasing the number of CPAT (Certified Patient Account Technician) credit balance analysts.
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ISO 9001:2015 & ISO/IEC 27001:2013
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HEALTHCARE BILLING
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RBMA Corporate Partner

From Our blog

10 Ways Healthcare BPO helps Hospitals to manage Revenue Cycle Management

Would you be passive when your bills are delayed and denied frequently? It ain’t simple for a healthcare to manage medical billing simultaneously.  If you haven’t considered the productivity of healthcare BPO so far, then we would recommend to heed the below.