Reverse Insurance Payment

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Updated: 05/06/2022
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Some situations require an insurance payment reversal (e.g., the insurance overpaid or paid in error). Once the applied payment amount is reversed, you can either refund the unapplied payment amount to the insurance or apply it later to another service line. Contact the insurance company directly for specific instructions.

Reverse Insurance Payment Click Encounters > Track Claim Status. The Find Claim window opens. Find the claim with the applied payment amount that requires the reversal and double click to open. The Edit Claim window opens. Under the Transactions section, double click the insurance Payment transaction line to open. The Edit Payment window opens. Note: The insurance Payment transaction line description includes the applied payment amount, Payment ID number, and payer.
Select the Apply tab. The additional payment details display. Click to select the appropriate patient if necessary. Click to select the appropriate encounter if necessary. Click to select the service line with the applied payment amount that requires the reversal. Click More + in the lower right of the window. Additional options display. If the service line was settled, click the drop-down arrow and select Reopen. Then, click Post.
Click the drop-down arrow and select 1 - Payment. Once selected, an additional field becomes available. Enter the minus (-) sign and the payment amount that needs to be reversed/unapplied (e.g., -12.34). Click Post. The Payment transaction line for the reversal is posted.
Confirm the posted Payment transaction line and Unapplied amount reflects the correct amount(s) reversed. If the posted transaction line needs to be removed, right click on the transaction line then select Remove. For additional actions (e.g., add note, settle service line), click the drop-down arrow to select the appropriate option and enter information as necessary. Then, click Post. Note: It is recommended to add a note indicating the reason for the payment reversal. When finished, click Save. The payment amount is now reversed and remains unapplied until a refund is issued to the insurance or the amount is applied to another service line.