Entering Insurance Over-Payment
Answered

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.

14 comments

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    Michael H

     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'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. 

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    Deborah Bressler

    Ok, this doesn't make sense to me.  We have to issue a check to the insurer.  Also what if the payment included another client.

    Ok, this doesn't make sense to me.  We have to issue a check to the insurer.  Also what if the payment included another client.

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    Katrina Mercer, MA, LMHC

    The payment did include several clients.  If I delete the check then it deletes it from other client's accounts.  Plus it doesn't show in my accounting that it is consider a refund.  Is there a way to make a refund show in a client's account? 

     

    The payment did include several clients.  If I delete the check then it deletes it from other client's accounts.  Plus it doesn't show in my accounting that it is consider a refund.  Is there a way to make a refund show in a client's account? 

     

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    Marlo Archer

    This is marked as answered, I still don't see that Katrina's question has been addressed. I am having the same problem. I'd like to be able to enter a negative (-) number as an insurance payment for the refund that was issued on 9/25 for service that was paid in Jan this year.

    This is marked as answered, I still don't see that Katrina's question has been addressed. I am having the same problem. I'd like to be able to enter a negative (-) number as an insurance payment for the refund that was issued on 9/25 for service that was paid in Jan this year.

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    Dr. Brittany Lakin-Starr

    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. 

    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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    Front Desk

    I don't show that this question was answered either, I'd be interested in the answer/outcome on this question. 

    I don't show that this question was answered either, I'd be interested in the answer/outcome on this question. 

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    Jenna Peterson

    I am also having the same problem. I can manually change the amount to reflect the corrected payment, but then I end up with unallocated funds and does not show an accurate accounting of what actually happened.

    I am also having the same problem. I can manually change the amount to reflect the corrected payment, but then I end up with unallocated funds and does not show an accurate accounting of what actually happened.

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    Cindy Failing

    I agree. I was a CPA prior to becoming an LPC. We need an audit trail. This is not a sufficient answer. Please give us an alternative to where we can leave the payment alone but now refund it in our SP records. 

    I agree. I was a CPA prior to becoming an LPC. We need an audit trail. This is not a sufficient answer. Please give us an alternative to where we can leave the payment alone but now refund it in our SP records. 

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    Kim Sullivan

    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).

    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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    Jacqueline Kirkbride

    I agree with everyone.  It would be great if we could have an audit trail that shows the refund given back to the insurance company.  I will make a note on the client's account but this could get messy!!!!

    I agree with everyone.  It would be great if we could have an audit trail that shows the refund given back to the insurance company.  I will make a note on the client's account but this could get messy!!!!

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    Kristin Effinger

    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.

    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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    Sherrie Gerry

    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.

    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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    Deby Williamson

    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.  

    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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    Ayelette R

    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.

    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.