Aug 27, 2024
Apr 3, 2025
Written By Elizabeth Cifers
Discovering a negative balance on an accounts receivable item at your retina clinic can be disconcerting. With Medicare’s 60-day overpayment rule, prompt and thorough investigation is required. However, avoid simply assuming the negative balance is the result of overpayment. There are a few reasons why a negative accounts receivable balance may occur—including one that does not involve overpayment.
1. Multiple insurers paid on the same item. Perhaps the patient was confused about who their primary is—you billed Medicare as primary and a commercial payer as secondary, but both insurers paid as primary. Benefits must be coordinated to determine the correct primary and secondary payers.
2. The patient and the insurer paid for the same item. Maybe the patient forgot to tell you they had secondary insurance. Once the primary insurance, Medicare, paid the claim, the balance was sent to the patient, who promptly paid. However, a month later, the payment from the secondary insurance that crossed over from Medicare showed up. A refund is due to the patient.
3. A false payment was auto-posted. For example, the insurer denied one line item for the services billed. You submit an appeal with documentation. After the documentation is sent, the claim is approved, but payment is auto-posted for all claim lines despite just one of the items representing actual money.
When a negative accounts receivable item is discovered, find the reason why. If it’s an overpayment, repay the party you’re obligated to and ensure similar overpayments are not occurring at your retina clinic. If it’s a false payment, make an adjustment, including why it is false. Sometimes, a patient wishes to carry a balance forward and apply the overpayment to future balances. If this is true, document the patient's conversation and wishes.
Negative accounts receivable items affect the metrics for the accounts receivable buckets they fall into and the overall accounts receivable, resulting in a muddy financial picture of your retina practice. Getting into the habit of cleaning up negative accounts receivable at the beginning of each month can give you a better idea of how your practice is doing.
At a time when financial clarity is more important than ever, hiring a billing consultant to decipher and correct errors like negative accounts receivable and the process issues associated with them is invaluable. Consultant Elizabeth Cifers has decades of industry expertise and can find a solution to any challenge you may be facing because chances are she’s solved a similar challenge before. Schedule a free initial consultation to discuss your retina practice’s needs here.
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