Tip from UnitedHealthcare on Balancing an Remittance Advice

Hayden Parker

A message from UnitedHealthcare regarding balancing a Remittance Advice (RA):

Here is our tip for the week on balancing an RA

Balancing a -$Paid Amount RA

Net Payable                       -$1490.90

Overpayment Amount    $-3333.20

Recovered Amount        $1209.30

Net Paid Amount             $0.00

$3333.20 is the total overpayment amount. If you add up all of the overpayments for this remit- it totals this amount. (look at the Summary of overpayments- remit date is 4/14 so look at all the new recoveries added to that list on 4/14). If you add up all of the overpayments listed by claim on the remit- it totals $2700.20. But if you look, there is no claim reversal for $633.00 to be seen in the body of the RA, however there was a claim# ending with "01" showing a payment in full, which prompted the original claim # ending with "00" to be listed and added into your Summary of overpayments. This is where the $3333.20 came from. $1209.30 was the actual paid amount on this RA. Take the $3333.20 minus the paid amount of $1209.30 minus the $633 since it wasn't listed as a claim reversal on the remit; this equals $1490.90.

You would review the Summary of overpayments page(s) to see which account (s) the $1209.30 needs to have the money transferred from providers accounting system to the paid claims account.

The claims that overpaid cannot be balanced at this time as they were setup as recoupments to be taken from future claim payments.

If providers would like they to make the recoupment process more timely with large amounts of recoupment funds, you are able to submit a check with a form showing which claims are being paid back in the form of the check.

Please contact your UHC Advocate if this is something you would like to do.