Posting Other Types of Payments

The entry of negative payments and adjustments can also be accomplished through payment entry. Negative payments can be used to process insurance recoupments, correct posting errors or to deallocate payments. You cannot mix regular payments and negative payments. When you want to enter a negative payment, you must enter a negative payment amount in the payment entry screen.

Processing Insurance Recoupments
When an insurance company issues a payment for one patient and at the same time deducts a portion of that payment to cover a refund owed for a different patient, it is called a recoupment. The insurance company has recouped a refund owed to them by deducting it from your payment. This allows the insurance company to get their money more quickly from you by not having to issue a refund request to your office. When they do a recoupment it does force you to take a few extra steps to properly post the payment and recoupment.

You will need to review the patient account the refund is being recouped for prior to posting the recoupment. You will need to make a note if any contractual adjustment was made when the payment was originally posted.

Select the patient account the refund is being recouped from and then complete the payment fields as shown.

Use the current accounting date that was used for the EOB.
Enter the payment amount as a negative amount (-50.00)
Use the same payment code that was posted on the original payment
In the Remarks field we suggest using 'recoup dos =XX-XX-202X'
Select the insurance carrier code
Enter the Date of Service if known

Click Save once you have completed these fields to proceed to the Payment Allocation screen, otherwise click Cancel to exit this function. If the original charge line item does not show up, click Add/Edit Filter, set Transactions to Display to Closed or All, type in the Date of Service and click Save. Any line items for that date of service should now be displayed.

If there are multiple line items, select the correct one and type in the negative payment amount to be applied in the Payment field. You can only apply a negative payment towards a charge. If there is a corresponding contractual adjustment, enter the adjustment portion as a negative amount as well.

Note: Negative Adjustments can only be posted through the payment entry function because when you process an insurance recoupment with a negative payment, you typically need to recoup the adjustment as well. This is what makes the circumstance slightly different than posting a regular debit adjustment. When you enter the dollar amount of the adjustment, type a negative sign in front of the dollar amount. This is the only differentiating factor between a regular adjustment and a negative adjustment. The negative adjustment can only be posted against a charge item. The reason for this is because internally, a negative adjustment really acts like a debit adjustment. All debit adjustments need to be assigned a doctor and location. The negative adjustment will utilize the doctor and location codes posted on the original charge item to update the statistical files.

You will notice the balances that display on the screen may look a little peculiar and/or inaccurate, but when the payment is actually saved, the system does all of the routine checks to determine what the patient and insurance balances should be. Only until this time can you be sure that the insurance and patient balances are correct. Click Save once the negative payment has been allocated.

Deallocating a Payment
When a payment has been applied incorrectly on a patient account, applied to the wrong account, or you need to deallocate a payment, you can use a negative payment to correct the account. This comes in really handy when your billing period has already been closed and the payment was posted prior to the closing date. Complete the Payment Entry screen as follows:

Use the current accounting date
Enter the payment amount as a negative amount
Use the same payment code that the original payment was posted with
In the Remarks field we suggest using 'correcting a posting error'
Enter the insurance carrier code
Enter the Date of Service if known

Click Save once you have completed these fields to proceed to the Payment allocation screen, otherwise click Cancel to exit this function.

If there are multiple line items, select the correct one and type in the negative payment amount to be applied in the Payment field. Click Save once the negative payment has been allocated.

Now you can re-post the payment correctly using the current accounting date. Select the patient account and then post the payment following normal procedures. The negative payment and reposted payment will both show up on the Bank Deposit report and cancel each other out.

Whether you allocate the re-posted payment or not depends on each individual scenario. If you are going to refund the insurance carrier or research the account, you should leave the payment unallocated so you will be able to apply the refund to it at a later time.

Posting Error
If you are correcting a posting error and end up re-posting the payment on a different account, you should enter a Remark that provides an audit trail (i.e. Pmt transferred from #9999 for MM-DD-YY)