Credit Balance Resolution Services

Mitigate compliance risks, prevent credit balance from escalating, and protect financial liability with PCH Health

30+

years of 
experience

24/7/365

support

3K+

RCM 
expert team

Accurate credit balance resolution solutions

PCH Health’s credit balance resolution services ensure regulatory compliance, transparency, and financial stability for healthcare providers. We scrutinize accounts to detect and rectify excess funds or overpayments owed to patients and payers.

Our experts possess in-depth knowledge of the credit reconciliation process and adeptly cater to the specific needs of healthcare providers. Our credit balance services include:

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Identification and examination of credit balances

Identification and examination of credit balances

Reviewing account transactions, ERAs, EOBs, patient historical notes, and related documents to pinpoint errors and conduct thorough credit balance analysis.

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Rectification of misposted adjustments and payments

Rectification of misposted adjustments and payments

Carefully examining insurance or service provider contract details to reclaim the allowable amount and rectify inaccurately recorded adjustments or payments.

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Generation of patient or insurance refund letters

Generation of patient or insurance refund letters

Crafting detailed patient or insurance refund packages with relevant supporting documents, prepared and dispatched according to client specifications and federal guidelines.

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Expansion of self-pay or secondary billing opportunities

Expansion of self-pay or secondary billing opportunities

Streamlining adjustments or payments to facilitate self-pay transfers or secondary insurance billing, thereby improving accessibility and efficiency.

Patient and payer credit balance services

At PCH Health, we meticulously review each patient's account, validate identified credit balances, and issue refund checks to clear the account balance.

Providers are required to process refunds within 60 days of the refund request date. We carefully validate each request and promptly process refunds for valid ones. If a refund request is found invalid after thorough validation, we initiate an appeal.

Partner with us to seamlessly manage your credit balances.

Patient and payer credit balance services
Benefits of PCH Health’s credit balance services

Benefits of PCH Health’s credit balance services

We have a team of experienced credit balance analysts ensuring:

  • Timely refunds of confirmed overpayments to payers and patients.
  • Enhanced patient/payer satisfaction through prompt resolution of credit balances.
  • Identification of root causes of errors and gaps to prevent recurrence.
  • Adherence to relevant Medicare payment regulations.
  • Minimized risk of non-compliance, litigation, and penalties

Awards and Certifications

Major Player
NelsonHall
PEAK Matrix Medical
Peak Matrix Healthcare

Top specialties managed by PCH Health include but are not limited to:

Ambulatory Surgical Center
Ambulatory Surgical Center
Behavioral Health
Behavioral Health
Cardiology
Cardiology
Oncology
Oncology
Orthopedics
Orthopedics
Primary Care
Primary Care
Urgent Care
Urgent Care

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