Insurance Takebacks/Reversals Overview

Insurance Takebacks/Reversals Overview

Sometimes a Payer will retract (Takeback) a Payment that has been previously paid. For example, the Payer may have discovered that the Patient was not eligible on that Date of Service. The retraction may be a partial Takeback or a full Takeback.

 

If the Remit with the Takeback is being posted manually, always post the Takeback first before posting the Payments on that same Remit. When a Takeback is done, money is added to the Escrow of the Receipt to be reallocated to Payments on other accounts.

 

If a Takeback is on an ERA, it can be Posted as Remitted or the Manual Post button on the ERA can be used.

Difference in Post as Remitted and using the Takeback function from Manually Payment Posting?

  1. Post as Remitted is an ERA Function
  1. This action posts exactly what the Insurance adjudicates on the Takeback.
  2. Why this might not be the correct action.
    1. If you did not post the original Payment As it was Remitted on the EOB, such as, Post as a Note.
    2. If the Insurance adjudicates the Takeback differently than they originally paid, such as, a Partial Takeback.

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