A Recoupment is when the insurance has overpaid on a service that was provided and was billed properly, but they are requiring that you apply the over-payment to another service for that patient or even another service for a different patient. It is important that when you are doing a recoupment, you are actually not editing the original EOB where the insurance company made the initial erroneous payment. You must keep that as is in order to reflect that the insurance company did in fact overpay on a certain charge.
The Recoupment process is done in two parts:
Part One – Recouping the Money
1. Select "Post New EOB" and add in all info as normal, but leave the check amount blank since you are not posting any NEW money, you are moving existing money.
2. Select “Next”.
3. You will notice the amount across the top is $0.00.
4. Select the patient’s name, the amount being recouped from that patient and click “Next”
5. Select the date of service the money is being recouped from and select “Apply Date Filters”
6. Once the filter is applied, select the green pencil to the far right of the charge.
7. Adjust the responsibility of the charge if needed. For example, if the responsibility is on the patient side, it may need to be moved to the insurance side.
8. Add the recoupment amount into the recoupment space provided and click “OK”.
9. Now you will see that the AMOUNT REMAINING area has changed to the recoupment total. Now we will tell the system where it needs to distribute this remaining amount (recoupment amount).
10. Click “next”.
Part Two – Re-allocating the Funds
The second part to doing a recoupment is to take the money that was recouped from a patient and reallocate it to another patient as requested by the insurance company. Keep in mind, when you begin the process to post the new EOB, you should NOT add the recoupment amount to the amount on the check. The check amount entered into VitaLogics should match the actual amount that is on the check.
1. Select the patient’s name the recouped money should be applied to.
2. Select the date of service the money is to be applied. Click “Apply Date Filters”.
3. Add the payment as you normally would post an insurance payment. Once the payment has been added, you will see the money in the “Amount Remaining” field has been moved to the “Amount Applied”.
4. Click “Next” and Complete the EOB.