Guidelines for Credit Balances and Refunds

When an account has a credit balance, determine the reason:

  • Posting error
  • Overpayment by third-party payer
  • Overpayment by patient (guarantor)

If the reason is an overpayment, process the refund procedure to the appropriate party in a timely manner.  

The recommended procedure is as follows:

  • Complete a refund request form (see sample below).
  • Attach a copy of the explanation of benefits (EOB).
  • Submit refund request form to business office manager for review.
  • If approved, send request and all attachments to the administrator for approval.
  • Issue a facility check to the appropriate payer.
  • Post refund information to the appropriate patient account.

Note: It is advisable for credit balances be corrected/refunded within 30 days.


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