Overview

This feature is beneficial in situations where a third-party payer has resolved a claim but later seeks a refund or clawback as a result of particular conditions.

note

Users with the privilege Track claims will be able to use this feature.

Users with the privilege Track claims will be able to use this feature.

How to use

  1. Highlight and R-click the payment on the patient sales history

  2. Select Process 3rd party clawback

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  1. Check the invoice(s) checkbox to use the full payment amount or double-click in the clawback amount cell to enter the partial clawback

  2. Click save

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  • Should you choose the full payment option, the initial payment will be removed from the patient's sales history and recorded in the third-party ledger.

  • In the event of a partial clawback, a portion of the patient payment will continue to be recorded in the patient sales history, while the remaining amount will be reflected in the third-party ledger.

  1. Go to Accounting > 3rd party ledger > select the 3rd party payer to find the payment

note

The 3rd party payer will be displayed in a greyed-out format at the bottom of the list due to the utilization of claims tracking.

The 3rd party payer will be displayed in a greyed-out format at the bottom of the list due to the utilization of claims tracking.

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  1. Highlight and R-click the clawback > apply to claim to use this payment for another patient.

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Clawbacks can only be applied to submitted claims

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