Remittance Advices Help You Track Your Accounts Receivable
When a claim is overpaid and then adjusted, it can result in an overpayment. When this occurs, a letter is sent to the provider requesting a refund within 60 days from the date of the letter. An automated process occurs when the letter is generated to insure that the money will be recouped (suppressed) from another claim from the provider if the refunded payment has not been posted in exactly 60 days. Seldom is a refund request received, researched, and responded to by the provider, then received and posted by the Plan before the 60 days expire. For that reason most overpayments end up being recouped. When an overpayment exists, it is always recouped from any subsequent HealthChoice claims, regardless of the patient.
When a claim is processed, but the actual payment is suppressed because of an existing overpayment, you can check the Accounts Receivable section of your Remittance Advice to see which payment was suppressed to satisfy an overpayment.
HealthChoice Network Providers can view and print their Remittance Advices online using ClaimLink for Providers accessible at www.healthchoiceok.com.