Issue a Refund to Insurance (Deactivated Contract)

Sometimes insurance overpays and asks for a refund. Here is how to handle it when the contract is no longer active in Tops Ortho.

1. Open the patient chart; go to View > Patient Info... or press Command I.
2. In the case of our example patient, Pepper, the practice received $1500 from insurance, but the benefit decreased to $1000. Now the insurance company is asking for $500 back. Currently, the Expected Insurance shows zero because $1500 was entered as the Calculated Insurance in Pepper's original contract.

3. Go to Action > Change Expected Insurance.
4. Select the option for I want to Increase the Expected Insurance by: and enter the amount to be refunded. Enter a note explaining the reason for the change.
5. The After Change column shows you that after the change, there will be a credit in the Due Now and a balance in the Expected Insurance.
6. Click Change Expected Insurance.

7. Go to Action > New Transaction or press Command T.
8. In the Fee/Payment Type field, select [+] Account Adjustment. Enter your Tops Ortho password.
9. In the Account Adjustment Type window that displays, select Refund to Ins. Co. and click Use Selected Adjustment Type.
10. Enter the amount of the refund to be issued.
11. In the Notes field, enter the check number and other pertinent information. Press Tab.
12. Click Process Charges and Payments.

13. Go to Action > Change Expected Insurance again.
14. Select the option for I want the Expected Insurance to be: and leave the This Amount field as zero.
15. Enter a note explaining the reason for the change.
16. The After Change column shows you that after the change, the $500 balance will move down to the Due Now.

17. If you are going to have the patient pay the balance, collect the payment.
18. If you are going to write it off, see the related article, Write Off a Balance, below.