Avoid being non-compliant and pay hefty fines with Clarus RCM’s Credit Balances Services. Returning excess money collected as compared to fees charged for medical services rendered is the responsibility of the healthcare provider. While credit balances could happen on account of a variety of reasons, the top reasons are an over-payment from the payer and excess patient payment in the form of a deductible or co-pay.

Credit Balances and the costs of non-compliance

Failure to process credit balances promptly could result in heavy legal costs, fines, and imprisonment. Hence it is prudent that a dedicated team of experts processes your credit balances each month to avoid such situations. Further, the negative impact on the brand can take years to recover from.

Additionally, excessive credit balances could provide an incorrect reading of the financial health of the provider, and hence timely processing can give you the right view of your financial health.

Often, healthcare providers have the same teams performing A/R Follow-up as well as credit balances, which drains productivity and creates a lack of focus.

Outsource your credit balance and refund processing to Clarus RCM to be assured of best-in-class service and avoid the risk of non-compliance.

Components of our Credit Balance and Refunds Processing Services

  • Credit Balance with Payers.

    • Validation. We validate each refund request, and if valid, process the refunds and reconcile the patient account.

    • Disputes. If we find a refund request to be invalid, we review the request again and file an appeal with the payer.

    • Prioritization of Refunds to Government Payers. Refunds to Government payers should be processed within 60 days from the time of refund request date. Our team prioritizes the request from Government Payers and processes the requests promptly.

  • Patient Credit Balance. We validate each account with a credit balance and process refund checks to the patient promptly.

Benefits our Credit Balance and Refunds Processing Services

Clarus RCM provides the following benefits to our clients on Credit Balance and Refund Processing services

  • Comply with all regulatory guidelines and protect your brand

  • Avoid the pitfalls of excessive credit balance causing erroneous judgment of your financial health

  • Improve Patient and payer relationships through timely refunds processing

  • Daily account support calls to address any issues

  • Reduce costs by as much as 50% through offshore delivery

Connect with Us

To learn more about our Credit Balance and Refunds Processing Services, please fill the form and we will be in touch.