Compliance with Credit Balance Resolution Rules Does Not Have to Be Difficult

Credit balances are unavoidable and time-consuming. However, by law, they must be resolved. This activity does not have to be difficult even for already over-worked billing staffs. Professional outsourcing services are available to help with this growing challenge.

These services can be customized to fit into your specific workflow and increase your staff’s productivity, allowing you to increase the volume of accounts resolved on a daily basis, without hiring extra FTEs.

There are professional outsource companies that specialize in enhancing the financial performance of your revenue cycle management and related processes. They act as your partner to work within your legacy billing systems to research accounts in credit status, determine the root causes of the credit, and take appropriate corrective actions to resolve your credit balances. They leverage their healthcare expertise, technology, and qualified personnel resources. There is no capital outlay required.

Incorrect adjustments, erroneous credits, and misuse of debit codes make the credit balance task challenging without precision.

In contrast, professional outsource analysts are diligent and well-trained to ensure outstanding credit balances are accurately resolved in an expeditious manner. Their services are highly client-centric. They understand a professional and cooperative environment is the key to resolving credit balances, many of which become account corrections, as opposed to actual refunds.

A professional credit balance outsource company will:

   ● Analyze accounts along with EOBs
   ● Work all assigned accounts – big and small-balances
   ● Resolve all accounts – inspect for patient liability or other adjustment issues
   ● Determine if double payments were made – if so, refund as required:
        — By patient and insurance carrier
— By two insurance carriers (both acting as primary)
   ● Check for duplicate payments made for the same account
   ● Provide credit balance analysts who are certified Patient Account Technician (CPAT) from AAHAM
   ● Offer the highest levels of security, with a SAS 70 Type II internal-controls audit, and HIPAA compliance

By allowing a professional outsource company to take charge of your credit balances, you can expeditiously decipher, process and post refunds, and/or handle account corrections to consistently ensure the overall integrity of your revenue cycle.