When managing a medical practice, keeping the books balanced is a priority. This task can be a difficult one, particularly when you have NextGen credit balances. These balances occur due to the mistakes of patients, payers, and billers. Perhaps the insurance company paid too little initially, leading the patient to pay more than their fair share. Sometimes patients simply read the billing wrong and overpay. And, of course, occasionally, your staff sends out an incorrect statement or keys in the wrong payment or adjustment amounts. A busy practice can end up with millions of dollars of credit balances, which artificially decreases your accounts receivable and leaves you vulnerable to more mistakes.To keep the practice's finances straight, TempDev, a leader in NextGen practice management solutions, recommends using their reporting solutions with NextGen EPM. NextGen offers some of the most advanced software in the industry, which simplifies your practice management duties. However, it can be a complex system due to its enormous flexibility and lends itself to user error and misconfiguration. TempDev offers NextGen EPM consulting services in these areas so you can maximize the return on your investment. They also provide you with additional NextGen support for specific tasks, such as eliminating patient credit balances within state guidelines.
Credit Balance ComplicationsCorrecting NextGen credit balances may seem simple, but there are a variety of complicating factors. For instance, the sheer number of them can be challenging to process. You may have thousands of them waiting to be addressed and don't know where to start. Often, the credit is a result of a claim or system error. This issue must be corrected, and the account adjusted quickly. In addition, state laws vary, meaning a provider in one may have to follow more stringent guidelines than one in another state. It's easy to unintentionally violate state law if you don't stay current with these rules and regulations. If the credit is legitimate, you must issue a refund within the individual state deadline. For instance, Texas gives providers only 30 days to refund a patient's money after they discover the overpayment, no matter the size of the discrepancy. Other states have different deadlines. Processing hundreds of small to large credits in time can overtax your billing staff. Failure to comply with state law means your practice can end up in trouble with the state medical board, leading to steep fines, unhappy patients, and bad publicity.Also, inaccurate AR can cause business decisions to be made on false assumptions. You are doing your practice a favor by promptly fixing NextGen credit balance issues, even when that means mailing out a lot of checks.
NextGen Credit Balance SolutionsIf your practice has a credit balance issue, TempDev can help. One of the best solutions we have developed for clients is a robust credit balance reporting solution. These reports assist in the categorization of true credit balances that are due a refund to a patient or payor from those that are posting errors that just need to be corrected. This categorization enables clients to parse out the workstreams to separate teams since they often require differing skillsets. Once the balances are correctly identified, TempDev can help you build parallel processes to fix these issues - ones that your billers can easily follow. Without this assistance, your staff can become overwhelmed by the sheer volume of credit balances that need to be refunded or adjusted. TempDev can also provide temporary NextGen biller staff augmentation services from TempBill to clear up the issues so your billers can focus on their other roles.
Helpful Tools to Solve NextGen Credit BalancesTempDev can also provide our advanced tool CreditFlow to assist in the correction of the credit balances that meet your specific workflows to handle the revisions and refunds. Other tools and solutions can include:
- Custom business intelligence, Microsoft Power BI, or Microsoft SSRS report solutions that identify volume and for ongoing maintenance
- Automatically move balances around to fix issues
- NextGen Reason Code Library review and adjustments
- Custom workflow processes for approvals for refunds
- General ledger interface for refund processing post-approval