Refunds

Overview

Refund Processing in MedSuite can be accomplished by moving refunds through a cycle in which they are requested, then "issued," and then paid.  Here is a sample scenario:

A refund request could be added by anyone in the office, such as a payment entry person who notices that a claim goes to a credit balance because an insurance carrier has paid twice.  Or, you could print a list of credit balance accounts to review to determine which of the credit balance accounts need refunds, and enter the refund requests accordingly.  A manager would then print a Refund Listing to review the requested refunds.  Then manager would change the status to "issued" on the ones that he/she feels really should be issued, or "revoke" the ones that should not.  The manager could then run a Refund Listing showing the "issued" refunds to get approval from the physician and/or practice administrator if necessary.   Once it has been determined that the refunds need to be paid and checks generated, the would change the status "paid" and post the refund adjustment to the account.

Account Listing - Credit Balances

You can run a listing of accounts with Credit Balances by going to the Reporting Menu and selecting the Account Listings report.  Select the Credit Balance Accounts option, and run now.  This listing shows basic information such as  the account and patient name, patient number, and balance.

Add Refund Requests to Refund Manager

When you have an account that needs a refund, enter it into the Refund Manager by going to the Queues Menu.  Once you are in the Refund Manager, select NEW.   Indicate whether the refund is to be issued to the account holder, plan, patient, etc.  Then search for the account and the plan, if applicable.   The address will default, but you may change it if necessary (for example, if an insurance refund should go to a different address than the claim filing address).  Enter the amount to be refunded, and a note to indicate the reason, if desired.  The Status will default to Requested, and the requested date will be the current date.

Print a Refund Listing

You can print a list of the Refunds by going to the Queues Menu and selecting Refund Listing.  It will default to run a Listing Only, with all Refund Status options selected.  You may un-check the Paid and Revoked options so that you do not see refunds that you've already processed or that you've revoked because they should not have been issued.  You may also enter a date range if you like to show refunds requested or flagged to be issued for the current month only.  The Refund Listing shows the Payee Name/Address, the patient name, who requested the refund and the refund note if they entered one, the refund amount, the current status of the refund and the date it was requested/issued/paid/revoked, if applicable.

Change Refund Status to "Issued"

After reviewing the requested refunds that may have been entered by anyone in the office, the manager may choose to change the status of the ones that really should be paid to "Issued."  The ones that should NOT be refunded should be "Revoked."

This is done by going back into the Refund Manager and Editing the refund.  You may bring up the refund by entering the refund number from the Refund Listing in the Quick Search, or by entering the patient's last name, etc.  Select the Edit option, and then you may change the status to Issued or Revoked, change the amount, the address, etc.

You may then run a new Refund Listing to show the refunds that are now flagged as "issued."

Change Refund Status to "Paid"

When you are ready to enter the refund adjustments and send the refund checks, edit the refunds and change the status to Paid.   Run a new Refund Listing to show all the refunds you are now going to "pay."

Enter Refund Adjustments

In Payment Entry, you should create a separate batch for the refunds you are going to enter.  The Payment Method is Other (because it is not a payment at all).  You could enter the check # in the Doc No field.  Blank out the Payment Type which defaults to Patient Payment.  Enter the Refund adjustment code in the Adj Type 1 field.

You may need to use the Show All option in order to display the charges.  Enter the refund amount on the charge line with the credit balance.  This should be entered as a negative amount, such as -14.00 as in the example below.  You should see the Open balance amount change, typically to 0.

Run a Payment Worksheet for the batch of refunds you just entered.  The total on the worksheet should match the total of the last Refund Listing you ran.