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PATIENT CREDITS

3 questions to help you handle patient credits

By Ranadene K. Tapio, MBA, CMRS, CMC, Guest Contributor  bio

How does your office deal with patient credits? More importantly, does your office deal with patient credits at all? Believe it not, not all offices do. There are several reasons why an office wouldn’t address patient credits—from just not knowing they should to not knowing how to being short staffed.

If you’re uncertain about how to handle patient credits, these three questions and answers will help you start the project.

Question 1: How do I know if a credit is required?

Well, is the patient still being seen for ongoing services?

If the answer is yes: When is their next appointment? Will they be seen within the next 30-45 days? If so, your office will have to decide if you’re going to carry the patient credit forward towards the next DOS, or refund it and have the patient pay again at next DOS.

If the answer is no: Refund the credit on the next credit issuing run.

Question 2: How often should I run my credit reports?

Most states have regulations on the timeliness of a patient refund once the credit is identified. In general, refunding patients within 30-days is a broad rule of thumb that could be considered.

How often you run and work your patient credits will play into this timeline. If you’re in a smaller clinic, with lower volume, you may wish to run and work this report quarterly; whereas mid- to larger sized practices may be more effective if they ran these reports monthly.

Question 3: Where should I start?

If you’ve never run your patient credit list before and there’s a high volume to deal with, you will need to prioritize your criteria and just work through them. Some suggestions include:

  • Just start at A and work your way towards Z
  • Entire list by highest/lowest dollar to lowest/highest dollar
  • By insurance class or carrier, with highest/lowest dollar to lowest/highest dollar

Systems and policies should be reviewed and updated to accommodate the changes that occur in your practice. Smaller volume clinics may grow and need to work these reports more often. After the first couple of cycles are worked through, mid- to larger sized clinics may need to change the method in how they run the lists.

Conclusion

However you decide to work your patient credit list, it’s a starting point. The way you initially tackle this project does not have to be the criteria you use forever. The first run through will be the most difficult, becoming more streamlined as you progress over time.


Ranadene Tapio is the president of MedCycle Solutions, which provides Revenue Cycle Management, Credentialing, Outsourced Coding, and Consulting Services to a number of healthcare providers in a variety of specialties.  She holds an MBA in Healthcare Administration & Management and multiple professional certifications. You can contact her at Randi@MedCycleSolutions.com or call 320-290-6448.


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