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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