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Insurance Takeback

Posted: Fri Oct 05, 2018 3:54 am
by gchopra
Once Insurance take back is done, there is mismatch in what primary insurance paid due to which I am unable to send claim to secondary payer. While generating secondary claim total paid amount exceeds billed amount due to this secondary payer is not paying up.

Please advise what changes should I make so that it can be corrected?

Re: Insurance Takeback

Posted: Fri Oct 05, 2018 9:38 am
by Gavin Walker
Did you make the take back an insurance take back adjustment type in Medisoft? A take back doesn't adjust the balance owed, but rather they are taking back money from a previous over payment. You'll probably need to work one-on-one with a trainer to sort out all the details on this one.

Re: Insurance Takeback

Posted: Mon Oct 08, 2018 1:17 am
by gchopra
Hi Gavin,

Thanks for replying, yes I did make it. Let me share a example if insurance company previously paid $40 but now after reviewing there are $40 but increasing co-insurance portion due to this the insurance 1 paid amount showing in my system is $80 but actually it should be only $40.00.

As a result of which I am unable to process secondary claim as secondary payer is stating primary paid more than allowed for the service.

Re: Insurance Takeback

Posted: Wed Oct 10, 2018 6:57 am
by Gavin Walker
The co-insurance portion needs to be setup as a deductible code type in Medisoft.