Insurance Takeback

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gchopra
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Joined: Fri Oct 05, 2018 3:14 am

Insurance Takeback

Post by gchopra » Fri Oct 05, 2018 3:54 am

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?

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Gavin Walker
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Re: Insurance Takeback

Post by Gavin Walker » Fri Oct 05, 2018 9:38 am

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.
Gavin Walker
Walker Tek Solutions, LLC
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gchopra
Posts: 2
Joined: Fri Oct 05, 2018 3:14 am

Re: Insurance Takeback

Post by gchopra » Mon Oct 08, 2018 1:17 am

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.

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Gavin Walker
Posts: 4204
Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
Contact:

Re: Insurance Takeback

Post by Gavin Walker » Wed Oct 10, 2018 6:57 am

The co-insurance portion needs to be setup as a deductible code type in Medisoft.

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