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Lions, Tigers, and Takebacks...OH MY!

Overview

Payers can perform a takeback for a variety of reasons; they may be processing a void or replacement claim or simply performing an internal audit. Payers can also apply takebacks in different ways, using the credits to pay future claims or requesting you send them a refund. Learn how to identify a takeback on your Procentive remits and how to correctly record takebacks within your Payments Module.

Identifying Takebacks

You can easily identify takebacks by the purple flags in the ERA Module and by a negative paid amount.

  1. Click on the ERA Module.
  2. Click on blue link in the column titled File Name.
  3. Locate a Claim (on the left side) that is flagged with a purple flag.​​
  4.  Click on the Claim number.
    • Claim information for the line you chose will now appear in the section to the right. If the payer has processed a takeback, this will be reflected by a negative Paid amount in this section. The payment line (SVC line) will also be highlighted purple. 

ml:      1.  add an and image above

2.  add - If you have not saved the ERA, go to Processing an ERA (link)

Decide If You Need to Save The Takeback

  • If the payer took back and paid the same amount for a given client and date of service (DOS) on the same remit, you do not need save this entry (since essentially there is no change to the clients account). 
  • Pay special attention to the claim numbers. It is common to see the same claim number listed multiple times with takebacks.  One claim will have the purple flags with the takeback and another claim with the repayment. 

How To Post a Takeback

  1. Click on the payments link (the link below the DOS)
  2. On the bill line, to the right of Amount, click new to create a new transaction. 
    • A blue box will appear listing saved ERA payment references.

      takebacks click new choose era.png
          
  3. Select the ERA that is taking back the funds.
    • The date and reference of that ERA will populate on a new line.
  4. In the Transaction Type column, click the down arrow down.gif to the right of Payment.
    • A blue box will appear.

      tackbacks choose tx type takeback.png
  5. Choose Takeback.
  6. Enter the amount the payer is taking back in the box (this must be entered as a positive number).
  7. Click Save.
    • A green Saved box will appear to indicate this transaction has been saved.
    • The Takeback Credits in the Payer section above will also reflect this transaction.
  8. Repeat steps 2-7 if there are additional takebacks on this claim/DOS.
  9. If you are expecting a repayment from this payer for this DOS (on the same ERA or a different ERA in the future), you must create an ad hoc bill

Note:  An ad hoc bill creates an outstanding balance for this payer/client/DOS.  This is necessary so that you can still track your account receivable. 

If you've previously sent the payer a void claim, that would be an example of where you are not expecting repayment. 

  1. Once you have completed all necessary steps in the Payments Window, close the Payments Window.
    • You will then return to the ERA window.
  2. Place a check in the Complete column for this claim, indicating that you are done processing this takeback.

takebacks complete checkbox.png

Apply Takeback Credits

Whether you are applying these takeback credit to this same ERA or a different ERA, follow these steps:

  1. Click on the Claim number.
  2. Click on the payments link.
  3. On the bill line, click new to create a new transaction.
  4. Select the ERA.
  5. In the Transaction Type column, click on the down arrow down.gif to the right of Payment.
    • A blue box will appear.
  6.  Select Takeback Credit.
    • A Credits window will open.  This window will list all available takeback credits.
  7. Select the amount that was paid from the ERA that matches.
  8. Enter the dollar amount in the Use box.
  9. Click Done in the upper right corner of this window.
  10. Click Save.
  11. Close the Window. 
  12. Place a check in the Complete column for this claim.

Additional Resources

 Although it's rare,  a payer might ask for a direct refund of the money:  Create a Refund.

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