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What Are Credit Balances in Healthcare? A credit balance is any account in a negative balance, caused by improper or excess payment made to a provider.
The term “credit balance” can be defined in a number of ways; however, we will define it as “improper or excess payment made to a practice/provider as a result of patient billing or claims processing errors.”
Simply put, a credit balance is an amount of money that is owed to a patient or insurance company by a healthcare provider. This can happen when a provider receives payment from an insurance company that exceeds the amount of the bill, or when a patient overpays for services rendered.
12 Ιαν 2024 · Providers are legally obligated to resolve credit balances in a timely manner under the Affordable Care Act (ACA). Medicare and Medicaid overpayments must be reported and returned within 60 days of identifying the credit balance, and failure to comply puts providers at risk of prosecution for fraud under the False Claims Act.
8 Φεβ 2023 · Healthcare revenue cycle management begins at the start of patient care at a healthcare facility and concludes when all claims have been collected and payments received. The process involves multiple steps to ensure accuracy, compliance, increased revenue, and patient satisfaction.
RCM systems allow healthcare staff to enter all the information required for claims processing, which helps prevent the need to revise or resubmit claims. Reducing denied claims saves providers time and money.
6 Απρ 2023 · Taking the time to audit and monitor charge capture processes gives providers the insight they need to proactively address issues before they have a chance to impact revenue.
