Solutions
Healthcare Credit Balance
Resolution
Resolving healthcare credit balances requires more than identifying an amount due. Each balance must be reviewed in context to determine the appropriate resolution and ensure the process is handled consistently.
Jenvin Healthcare Partners combines experienced healthcare revenue cycle expertise with a structured approach to help organizations move credit balances toward appropriate resolution while gaining greater visibility into the process.
Beyond Simply
Issuing a Refund
Resolving a healthcare credit balance requires understanding why the balance exists and what action is appropriate.
Not every credit balance represents an amount that should automatically be refunded.
Credit balances can have different causes and require different actions. A consistent resolution process helps ensure that each account is evaluated appropriately rather than treated as simply another item on a worklist.
Jenvin brings structure to the process by combining account-level review with experienced judgment and clear documentation.
THE BALANCE
IS ONLY THE
BEGINNING
REVIEW
DETERMINE
RESOLVE
DOCUMENT
A MORE INFORMED
CREDIT BALANCE
RESOLUTION PROCESS
Effective healthcare credit balance resolution requires more than identifying an account with a negative balance. Each account should be reviewed to understand the source of the credit, determine the appropriate disposition, and document the resolution.
01
02
03
04
REVIEW
VALIDATE
RESOLVE
DOCUMENT
Examine account activity and history.
Determine
the source
and validity
of the credit.
Take the appropriate resolution action.
Maintain a clear record
of the action taken.
Appropriate Resolution
Matters
Healthcare credit balances can result from multiple types of account activity, including payer overpayments, patient payments, adjustments, duplicate payments, and other revenue cycle activity.
Determining the appropriate resolution requires understanding the account, not simply responding to the balance shown.
Experienced review helps organizations determine whether a balance requires a refund, adjustment, additional investigation, or another appropriate action.
Resolution
Requires
Context.
ACCOUNT HISTORY
PAYMENT ACTIVITY
ADJUSTMENTS
PAYER ACTIVITY
DOCUMENTATION
BEYOND THE
INDIVIDUAL ACCOUNT
Resolving individual credit balances is important, but patterns across a larger population can provide additional insight into the processes creating those balances.
ACCOUNT ACTIVITY
Understand what occurred within individual credit balance accounts.
RECURRING PATTERNS
Identify similar credit balance activity occurring across the broader population.
REVENUE CYCLE INSIGHT
Recognize patterns that may point to areas requiring further investigation or revenue cycle process improvement.
Supported by CreditResolve™
Technology Supporting the
Credit Balance Resolution Process
CreditResolve™ provides purpose-built technology to support healthcare credit balance resolution workflows, activity tracking, and visibility across the resolution process.
Combined with Jenvin Healthcare Partners' credit balance expertise, the platform helps bring greater structure and consistency to the review and resolution of healthcare credit balances.
CREDITRESOLVE™
ORGANIZE
PRIORITIZE
TRACK
DOCUMENT
Bring Greater Clarity to
Credit Balance Resolution
Whether your organization is managing a growing
credit balance population, addressing a backlog, or
evaluating its current healthcare credit balance
resolution process, Jenvin Healthcare Partners can
help bring greater structure, visibility, and expertise
to the work.