1. Refunds Chapter 29

2. Objective  Refund overpayments and duplicate payments

3. Key Concepts  Refunds to payers  Duplicate payments  Overpayments  Refunding all of a payment  Refunding a portion of a payment  Unapplied payments  Unidentified payments  Refunding on a line item  Refund batches  Closing a refund batch  Refund check process

4. Refund Processing  Sometimes payers (insurance companies. Employers, patients, guarantors) pay money to a facility in error  In these situations the facility refund the payer for all or portion of payment(s)  Duplicate payments  Paying more than is owed  Paying the wrong medical facility  Paying for services for which another payer already paid

5. 2 Types of Refund Situations  1. Refunding all or part of a payment when there is no invoice to which to apply the money(unapplied) payment)  2. Refunding overpayments on line items with an invoice

6. Basic Workflow Steps in Refunding a Payer  1. The payment entry staff member creates an open refund batch to collect the refund info  2. ….identifies that a payer should receive a refund  3. ….records the amount of the refund  4. ….records who should receive the refund check  5. ….collect the refunds for a certain period of time into a batch  6. ….send the refund requests to accounts payable  7. ….writes refund checks and mails them  8. ….sends copies of checks with refund requests back to payment entry staff  9. ….records refund check info in refund records  10....once all of the refund request records have refund check info recorded, the refund batch automatically closes

7. Payment Batches  Payment Batches screen showing all balances-Figure 29-1  Do This! Pg. 368  To add a new batch of payments click Add button Payment Batch; Add screen appears-Figure 29-2  Do This! Pg. 369  Add screen for adding individual payments-Figure 29-3  Entity/Payers: Select screen-Figure 29-4  Do This! Pg. 371  Payment Posting screen-Figure 29-5  Payment Posting Screen showing payment information recorded- Figure 29-6  Invoices Applied by Payment screen displaying invoices paid by this payment-Figure 29-7  Do This! Pg. 374

8. Payment Batches  Payment: Add screen for patient payment-Figure 29-8  Patient Select screen for patient-Figure 29-9  Do This! Pg. 376  Payment Posting screen for patient payment-Figure 29-10  Payment Posting screen after posting patient payment- Figure 29-11  Do This! Pg. 378  Batch Payments screen for refunded payments-Figure 29- 12  Do This! Pg. 379

9. Creating A Refund Batch  Billing Menu-Figure 29-13  Refund Batches screen-Figure 29-14  Refund Batch: Add screen for patient refunds-Figure 29-15  Refund Batches screen showing patient batch record- Figure 29-16  Do This! Pg. 382

10. Refunding Unapplied Payments(Or Unidentified Payments)  Billing Menu-Figure 29-17  Accounts Receivable Aging Dashboard with unapplied payments-Figure 29- 18  Payments by Balance screen showing Nationwide-Figure 29-19  Private Insurance Payments screen showing Nationwide-Figure 29-20  Do This! Pg. 385  Refund screen for Nationwide payment with no data-Figure 29-21  Refund Codes screen-Figure 29-22  Refund screen for Nationwide payment showing data-Figure 29-23  Refund Detail screen for Nationwide refund-Figure 29-24  Accounts Receivable Aging Dashboard with no unapplied payments-Figure 29-25  Do This! Pg. 389

11. Refunding An Overpayment Of A Line Item  Accounts Receivable Aging Dashboard showing the drop-down list for Activity-Figure 29-26  Accounts Receivable Aging Dashboard reset to overpaid invoices-Figure 29-27  Invoices, Overpaid, Credit AR screen showing Nationwide invoice-Figure 29-28  Payments Applied On Invoice screen for patient invoice-Figure 29-29  Payment Posting screen for second patient payment-Figure 29-30  Adjustment Codes screen showing refund codes-Figure 29-31  Payment Posting screen showing refund data input-Figure 29-32  Payment posting screen showing refund data processed-Figure 29-33  Payments Applied on Invoice screen showing patient refund-Figure 29-34  Do This! Pg. 397

12. Submitting A Refund Batch To Accounts Payable For Payment  Refund Batches screen showing patient refund-Figure 29-35  Refund Master screen showing patient invoice refunds-Figure 29-36  Refund detail screen for Nationwide refund-Figure 29-37  Refund detail screen for patient refund-Figure 29-38  Refund Master screen for patient refunds-Figure 29-39  Refund Batches screen showing patient refunds-Figure 29-40  Refund Batches screen showing patient batch submitted-Figure 29-41  Do This! Pg. 402

13. After Accounts Payable Writes The Refund Checks  Refund screen for Nationwide showing the refund check data-Figure 29-42  Refund Master screen showing Nationwide refund not pending-Figure 29-43  Refund screen showing the patient refund check data- Figure 29-44  Refund Master screen showing both refunds not pending- Figure 29-45  Refund Batches screen showing a balance of zero-Figure 29-46  Do This! Pg. 407

14. Printing The Refund Batch Print  You will need to print the refund to turn in for your assignment  Do This! Pg. 407