Credit Balance Resolution Services
On-time Credit Balance Processing. Compliant Processes.
Credit Balance Services
Credit Balance Services
One of the most significant risks in the healthcare revenue cycle is Credit Balance – the excess money received compared to the medical services rendered charges. While there are many reasons for credit balance situations to occur, over-payments from payers and excessive payments could be from deductibles, and co-pays are the primary reasons for credit balance. The healthcare provider must refund such amounts to the appropriate party – payer or patient.
One of the most significant risks in the healthcare revenue cycle is Credit Balance – the excess money received compared to the medical services rendered charges. While there are many reasons for credit balance situations to occur, over-payments from payers and excessive payments could be from deductibles, and co-pays are the primary reasons for credit balance. The healthcare provider must refund such amounts to the appropriate party – payer or patient.
Compliance Risks from Credit Balances
- Litigation and Fines: Failure to refund credit balances promptly could result in Litigation and significant fines or even imprisonment.
- Inaccurate understanding of the A/R situation: An excessive credit balance can provide an inflated view of the practice's financial health and lead to erroneous financial decisions.
- Impact on the productivity of A/R team members: Deployment of additional resources or shifting resources from the A/R team to resolve credit balance reduces team productivity.
- Loss of Credibility: Litigation creates negative publicity that reduces patient flow to the practice.
Refunding Credit Balances
- Patient Credit Balance: We analyze each patient's account, identify and validate credit balances, and initiate refund checks to zero out the account balance.
- Credit Balance with Payers: Providers should process refunds within 60 days from the date of the refund request. We validate each request, and if found to be valid, we process the refund. If the refund request is invalid, we raise an appeal after thorough validation.
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Our users are Happy & Healthy
Proficient FTE Handling
Behavioral Collections Up by 50%
Credentialing Simplified
Lightning-Fast Support
Proactive AR Management
Finally Stress-Free
Cardiology Denials Cut by 35%
Healthcare partnerships
Effectively Combat Clinical Denials and Shift Focus to Denial Prevention
Benefits of Our Credit Balance Resolution Services
Significant Cost Savings
Achieve over 50% savings with our offshore trained pool, significantly reducing operational costs while maintaining high-quality service.
Protect Brand and Market Image
Ensure an efficient and error-free process, safeguarding your organization’s reputation and market image.
Improved Relationships with Healthcare Payers
Enhance collaboration and understanding with payers, leading to smoother transactions and reduced conflicts.
Eliminate Litigation and Fine Risks
Reduce the likelihood of legal issues and financial penalties through meticulous compliance and accurate credit balance management.
Financial Accuracy and Compliance
Maintain regulatory compliance and reduce audit risks by accurately reconciling accounts.
Improved Revenue Cycle Management
Streamline your revenue cycle for faster turnaround times, improved cash flow, and enhanced patient satisfaction.
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