Corporate Compliance

Tip: Credit balances

Compliance Monitor, November 29, 2007

Create procedures that guarantee timely and accurate reporting of Medicare and other federal healthcare program credit balances. For example, a hospital may redesignate segments of its information system to allow for the segregation of patient accounts reflecting credit balances. The hospital could remove these accounts from the active accounts and place them in a holding account pending the processing of a reimbursement claim to the appropriate program. A hospital's information system should be able to print out individual patient accounts that reflect a credit balance in order to simplify tracking of credit balances.

A hospital also should designate at least one person to be responsible for the tracing, recording, and reporting of credit balances. As an additional safeguard, each month a controller or accountant should review reports of credit balances and reimbursements or adjustments.

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