Credit Balance Reporting (video)
Healthy Connections (SC) Medicaid: Credit Balance Reporting video
Script for video:
If you have a credit balance, you’ll need to report that to the South Carolina Department of Health and Human Services. What’s a credit balance? For instance, you may have been reimbursed by both Medicaid and by another third-party payer for the same services. This creates a positive amount in that patient’s account. The credit balance quarterly review will assist in identifying those credit balances, so that Medicaid can be refunded. Institutional providers will need to mail or fax in a Medicaid Credit Balance Report by the 30th day after the quarter’s end. This process is ongoing, so let’s take a look at what you’ll need to do.
First, you’ll need to review your records to identify any credit balances. Next, fill in a Claim Detail form for each one. Key information includes the: provider, beneficiary, claim, service, and payment details. You’ll indicate the amount Medicaid paid and the amount you identified as a credit balance to be refunded. You can choose to attach a check or have the amount auto-debited by the program. If there’s still a credit balance outstanding, indicate why that is. Complete the Claim Detail report by identifying yourself. The next step is to complete the Certification Page. An officer or administrator in your organization must sign this form validating all credit balance reports attached. If you didn’t have any credit balances, simply check that option.
Now you’re done. Just gather together the certification page, any credit balance claim detail reports, and any checks. Fax them to this number [(803) 462-2582]. Or, mail them here [P.O. Box 8355, Columbia, SC 29202-8355]. Then, just make preparations to send your next credit balance report by the 30th day after the next quarter’s end.