How to handle an insurance take back in Medisoft

Have you ever gotten an “Insurance Take-back” and not sure what to do about it in Medisoft? An insurance take-back is where the insurance company made a payment to you on a cliam for a certain patient, and then later decides that they overpaid on that patient and tells you to apply the overpaid amount to a different patient. So, they are taking a portion of a payment back, and applying that portion somewhere else.

When this happens, if you don’t enter it all in to Medisoft correctly, it can make a little mess of things. Watch this quick video to learn how you can apply an Insuranct Take-back into Medisoft.

Watch the video here…

Video Transcript:

Hi. Today we are going to look at how to apply a take back in Medisoft. In order to do this we would first need a patient with an insurance payment already applied. So here we have our tutorial database and we are going to look at the patient, Dwight Again.

We see that he does have a couple of Medicare payments that have been applied. So is what we need to do, let’s say we get a take back in the mail and Medicare decides that they overpaid and they want to recoup some of that money. So we go ahead and click on New and create a new service line. Drop all the way down and look for the code ‘TAKEBACK’.

Your system may not have this, you may need to create it. If that is the case, then just right click on the Payment/Adjustment code line and click on New Procedure. We are going to actually look at it right now. You can name it whatever you want but we normally name it ‘TAKEBACK’, have the description be Insurance Takeback. Then we want the code type to be Insurance Take Back Adjustment. Click okay.

Who Paid – here you are going to select the insurance that is doing the Takeback and in this case we are going to do Medicare. You can put in the description, many times when they are doing a Takeback, rather than actually requesting their money back they will be re-applying it to another patient. So you can say Reapply to Johnny. We can put in our Amount, let’s say they want to recoup $30. And then we’ll go ahead and hit Apply. Let’s say we do $15 here, $10 here, and $5 down here. And again, you would get these amounts off your EOB where it would have all of this information.

If we read this it says that the deposit list will not be adjusted, will not have its applied amount adjusted, excuse me, we will have to go and adjust that ourselves. We’ll go ahead and click on okay. In order to adjust that we can do a couple things here. What I would recommend is go to the Quick Ledger, and look at the payments. These are the three payments we adjusted that we are imagining we are doing the take back on. Highlight one and click Payment Detail, and we can see when that payment was initially applied. So it looks like 12/4/2009. Then we go to our Deposit List and just pop in that date, and here is the Medicare payment. So is what we want to do is double click and put in Unapplied Amount of $30, then hit Save. And then we can now go in and apply that remaining $30 now to Johnny.

This is a way that insurance company’s kind of shuffle around their money when they do overpayments or when they look into a case and find that they paid too much or the patient was not actually covered. So that is what they do. It is called an Insurance Takeback and that is how you apply it.