Health Plan Payment and Reimbursement

Ask the Experts: Credit Balances

May 8, 2018 11:11 am

How do other Florida hospitals initiate and work credit balances? Do they issue the refund once the credit balance is found, or do they wait for the request by the health plan? If a credit balance is found and no request for the refund has been given, does the hospital wait for the 30 months? Also, are there any hospitals that use a credit balance company to work the credit balance?


Answer: We are not a Florida hospital, but I can say that we issue the refund when the credit balance is found. We don’t wait for a request. It is true that you could refund and then find out a request was issued from the health plan at the same time. That can be frustrating but it’s better to get the refund done.

We don’t use a credit balance company, but there is one large health plan who offers personnel to review credit accounts for patients with that coverage, and subject to approval by us will go ahead and do the credit processing. This works for us.

This question was answered by: Ruth Landé, senior vice president, patient revenues, Memorial Sloan-Kettering Cancer Center, and a member of HFMA’s Metropolitan New York Chapter.

What do you think? Please share your thoughts on this question in the comments section below.  

The information provided through the Forum’s Ask the Expert service does not constitute legal advice, even when the advice is provided by lawyers. You need to obtain your own legal counsel for legal advice and consider the laws and regulations that govern your state. The content and opinions expressed are those of the Forum experts, and not that of their employers or of HFMA. HFMA does not endorse the material or warrant or guarantee its accuracy. The responses are based only on the specific facts or circumstances provided. Forum experts cannot be held liable for outcomes related to any information provided. 

Pose another question to our Revenue Cycle Forum experts.

Advertisements

googletag.cmd.push( function () { googletag.display( 'hfma-gpt-text1' ); } );
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-text2' ); } );
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-text3' ); } );
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-text4' ); } );
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-text5' ); } );
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-text6' ); } );
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-text7' ); } );
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-leaderboard' ); } );