Entering Insurance Over-Payment
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Premera Blue Cross reimbursed for a session for a client that did not have coverage at the time of session. They are now requesting a refund for overpayment. How do I enter this in the clients account? And also have it reflect in my accounting?
Thank you.
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I'd recommend reaching out to the payer directly for information about how to refund a payment. This depends on the payer - most of the time, they'll have you write them a check. Because you receive your payments from insurance outside of SimplePractice, you'll also refund them outside of SimplePractice.
After you refund the payment to the insurance company, you can remove the payment from SimplePractice to keep your accounting neat. To delete an insurance payment, simply navigate to Billing > Insurance. Then, find the payment you'd like to remove, click "edit," then click "delete payment."
Our Help Center has a step-by-step walkthrough on this here: Deleting an insurance payment
Let me know if you have any additional questions about this, or anything else SimplePractice! I'm here to help. -
I am having this same problem. BCBS pays us a lump sum for all patient claims processed on her same date at one time. If one patient requires an insurance refund, we cannot delete their individual payment. I can correct it in the original payment to show the correct paid amount, but then it shows unallocated funds. I would be nice to be able to enter a negative payment.
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In addition to what the others have pointed out, the accounting problem is made worse by Simple Practice's (typically very useful) automatic accounting feature.
I accidentally submitted a batch of insurance claims on a client earlier this year when transitioning over from using a billing service to using SP's billing function. Most of the claims had already been paid by UBH, which ended up paying me again. I issued a check for the repayment, but they removed the second remittances from their accounting by adding negative values on EOB statements, which were then automatically added to my client's account by SP. This resulted in several statements being reported as having unallocated amounts (which they really didn't).
I can resolve this manually, but want to add that this is another instance where a paper trail will be missing.
It would be very helpful if SP would allow for entering provider payments TO insurance companies (in the case of correcting remittances) and the ability to enter negative numbers in amounts paid (which it seems the auto enter did, but resulted in error messages similar to those that appear when you manually enter an insurance payment of $0).
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I agree. There are many things that need to be updated with posting & recording insurance transactions. I also find it frustrating that SP will answer a question with standardized instructions of what their software can do but never answers the question. Just say the software doesn't have that capability and they'll forward it to their software development.
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You have to make sure that you take down every piece of information about that payment - check number, date of payment, dates of service and all of the clients included in the payment. After you have all of that information, delete the payment and manually enter the payment back in without the amount for the client that didn't have eligibility. This way, every other client has their dates of service paid for correctly and the client you're repaying the insurance company for has the correct balance as well.
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This is NOT answered. Nor is the answer given sufficient. Modern, relational databases (such as this one) can absolutely allow for multiple entries per date of service to make the history of a given claim clear. It is simple -- even standard -- programming. The history of a claim is absolutely crucial information and should be available in this program that is all about claims and their history. This database should allow for the initial payment, for duplicate payments, and for the refunds we must send to insurance to all be entered -- for as many rounds as we must go with the insurance payer to resolve problems. The answer cannot ever be "delete the payment" for any situation in which duplicate payments are made and refunded.
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Hi everyone,
Earlier this year we released an updated feature related to adding insurance payments into your account. You can now enter a negative amount to reflect a refund sent to the insurance payer. Feel free to check out the details here: Adding negative insurance payments.
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The "Adding negative insurance payments" feature does not fix the problem. If the clinician is using their own bank account to repay the overpayment to insurance with a check, where do we enter that? I tried to use the 'Add Payment' function with a negative amount on the client's profile, but that only gave the client credit, which is wrong.
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In the "Check Number" spot, you could put BC1234 (Business Check and then the check number) so that you know it is from your business account. Most insurance checks have six or more numbers so that is how I know I sent them a check, my check number is only four numbers. I also make an administrative note on the client's chart, as well, to indicate that I've sent the check to the insurance company.
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I tried this and it worked for me to do a negative payment in the same fashion as if I was adding a regular payment. However, it would not let me put in a negative amount for the adjustment as well. I had to go back in to the original duplicate payment and edit it. I then added an administrative note about the refund and noted my business check number that was used for the refund. And, of course, kept all supporting documentation!
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Still this does not fully answer the question. I want to be able to enter a negative amount in the insurance payment section and the write off section, to get rid of the unallocated insurance payments. There are times when the insurance company pays us, takes it away, and then pays more (usually due to Covid policies). Regardless of the reason, I have come to terms that my unallocated insurance payments will remain there forever! I don't like it.
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THIS IS ABSURD!! I can't believe there's not away to make an insurance adjustment. This is "Billing 101." I've spent an hour trying to figure out why I have unallocated insurance payments. Come to realized It was due to corrected claims. Then I was trying to figure out how to reflect this in my accounting, and there isn't one. It's not accurate to go in and change a payment!! There should be a way to make adjustments. There's not even away to add a note next to the payment. You have to make a note in each patient's account who's affected. This is cumbersome and confusing.
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Hi! I just figured out how to fix this so you do not have an unallocated amounts left over. You need to go to the client's profile and go to payments. When you are adding in the recoup as a negative for the new payment, if you look for the DOS it is referencing to below where you enter the new payment you will see there is the ability to enter in above the original payment, the negative amount from the new payment. That will take care of your unallocated amounts, you do not need to put a negative in the write off portion. I hope I was able to explain it in a way that everyone understands. Let me know if you have any questions!
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