Correct an Insurance Payment Posted to the Incorrect Insurance Ledger

Let's start with a friendly reminder! If you have open claims associated with insurance policies that are no longer active for a patient, it's a good time to close them as part of your regular claims maintenance workflow. Leaving old claims open can make it much easier to accidentally post an insurance payment to the wrong claim or insurance ledger.

An insurance payment may occasionally be posted to the wrong insurance ledger. This can happen when:

• A payment is applied to the wrong open claim during payment entry.
• "Claim Not Listed" is selected in the Multi-Claim Transaction window, and the incorrect insurance ledger is chosen.
• A patient has multiple active insurance policies, or open claims remain from previous insurance policies, making it easy to select the wrong claim or insurance ledger.

Although a patient can have up to four active coordinating insurance policies, they may also have open claims associated with insurance policies that are no longer active on their chart. Taking a few moments to periodically review and close unnecessary open claims can help prevent posting errors and keep your claims workflow running smoothly.

Before You Begin

If the payment:

• Was processed through TopsPay, or
• Has already been marked as deposited,

the payment cannot be voided. I

Option 1: Addresses how to void and repost the payment

Option 2: Addresses how to document the misapplied payment.

If you feel more comfortable having a Tops Support specialist assist you, please don't hesistate contacting our knowledgable team for assistance.

Email: [email protected]

Phone: 770.627.2527

Option 1: Void and Repost the Payment (Recommended)

Whenever possible, the recommended solution is to void the payment and repost it correctly.

If the payment has not been processed through TopsPay and has not been marked as deposited:

1. Void the insurance payment.
2. Repost the payment to the correct insurance claim and insurance ledger.

For instructions on voiding a payment, refer to the Voiding Transactions article.

Option 2: Correct the Insurance Records Without Voiding

If the payment cannot be voided, update the patient's records to accurately document the payment.

Review the Claims

1. Open the patient's chart.
2. Select the Claims tab.
3. Identify the claim that should have received the payment.
4. If appropriate, add an Internal Note explaining that the payment was received but accidentally posted to the wrong insurance ledger. (highlight the claim, right-click and select Edit Claim...)
5. Close any unnecessary open claim(s) that remain open due to the posting error.

Update Remaining Benefits

Adjust the Remaining Benefit amounts for the affected insurance policies.

• Reduce the Remaining Benefit for the insurance that should have received the payment.
• Restore the Remaining Benefit for the insurance that received the payment in error.

If multiple insurance policies are involved, verify that each Remaining Benefit accurately reflects the patient's available benefits after the correction.

Document the Correction

Add an Insurance Ledger Note to each affected insurance ledger documenting the correction.

To create a ledger note:

1. Navigate to Action > New Transaction > Insurance Ledger Note.
2. Record which insurance ledger received the payment in error.
3. Document which insurance should have received the payment.
4. Include any additional notes that may be helpful for future reference.

Documenting the correction provides an audit trail and helps explain the discrepancy if the patient's account is reviewed later.

Important

The insurance payment has already been applied against the patient's Expected Insurance balance. Because of this, no adjustment to the Expected Insurance amount is necessary.

Preventing Future Posting Errors

Before posting an insurance payment:

• Verify the claim selected in the Multi-Claim Transaction window.
• If using "Claim Not Listed," confirm that you are selecting the correct insurance ledger.
• Be aware that open claims may exist for insurance policies that are no longer active on the patient's chart.
• Review both the claim and the insurance ledger before completing the transaction to ensure the payment is posted correctly.