Takebacks (Reversals)

You should, generally, post the takeback or reversal FIRST.  This will allow easy application of that money to another account as the insurance adjudicates.   In the case of ERA payment posting, one receipt will contain the takeback, if a payment was made, the receipt is for a negative amount.  In the case of manual payment posting, the money we take back is added to the escrow of the receipt to be reapplied to other accounts.  

What is the difference in 'Post as Remitted' and using the Takeback function from Manually Payment Posting?

Post as Remitted 

• From the Remit > Claim Action Dropdown > Post as Remitted
  

• This action post exactly what the Insurance adjudicates
  

• Why this might not be the correct action-
  

• If you did not post the original claim 'As Remitted' such as 'Post as a Note'  
  
• or if the insurance adjudicates the takeback differently than they had originally - see the examples below
  

Takeback  

• From the Manual Insurance Posting page  > [Takeback]
  

• This action takes back the EXACT payment posting from the original receipt onto your current receipt  
  

How to use [Takeback] button

The [Takeback] function is Receipt based.   When using this function, one is taking back exactly what was originally posted.

From an Insurance Receipt (IP):

1. Key in the Encounter number, tab
   
2. Click [Takeback]
   
3. Look for the RECEIPT number, DOS, Payment combo that should be 'taken back'
   

• click in checkboxes per line item, CPT
  

1. SAVE
   
2. The IP, Insurance Payment, amount will be added to Escrow.  
   

• In ERA posting the receipt may be created as -25.94 which will result in a Zero amount in escrow
  
• In manual payment posting, the user can then use the money in Escrow to post to other Encounters
  

What if a reversal or takeback does not post correctly?

In some cases the insurance will send a takeback or reversal of a previous payment in the ERA.  Most of the time we can use the 'Claim Action', 'Post as Remitted'.  However, sometimes the insurance will send a CR or other code that isn't the same as was originally remitted.  In these cases the accounting won't be correct if using 'Post as Remitted'.

Notice in this example the 'After Posting' area indicates the posting is incorrect

Instead we should use [Manual Post], then [Takeback], then check the boxes that represent the items being 'taken back' > Save. 

How to deal with a Takeback that is GOING to happen (future takeback)

In some cases, the insurance indicates at the line level there is a takeback, only to indicate at the provider level the takeback is going to happen in the future.  You may notice this on the EOB or on the ERA Dashboard.

See an example of this in the EOB below:

See example of ERA Dashboard

Receipts are only created for the Line Level adjudication.  In our example receipt 2075 has a takeback amount of 76.81.

We recommend changing the Receipt amount to $0.00

From the ERA remit page:

1. Click the Receipt number link that represents the 'future' takeback
   
2. Click 'Modify' on the Receipt
   
3. Type 0.00 in the 'Received' field
   
4. Save
   

1. Return to the Remit        
   
2. Update the Remit Status from 'On Hold' to 'Posted' or add to a Worklist
   

What if the Takeback is from an Insurance that is no longer on an Active Profile?

At times, we have updated/ rebilled to a new (corrected) insurance before a takeback is requested from the original insurance.  Frequently users will make this old profile 'Inactive' by un-checking the 'active' box.  We will need to temporarily change the profile back to the original insurance, by making it active and moving the encounter to that profile, to post a takeback. 

Go to Insurance Management

Be sure the original profile is active.

1. Highlight the profile where the Encounter is now
   
2. Select the Encounter we need to post to
   
3. Click [Change profile/rebill]       
   

1. Use the drop down to Change the profile - uncheck the rebill box
   
2. [Save]
   

After you are done posting the Takeback, move the Encounter back to the correct profile.