03/09/2026
Your patient should never have to ask for a refund. 😤
If a patient is calling your office to ask for a refund, your internal process has already failed them. They are not your bookkeeper. Tracking down money you owe them is not their job.
Credit balances happen in every practice. Insurance pays differently than expected. Copays and co-insurance get collected at the time of service and the EOB tells a different story. That's normal. What is NOT acceptable is letting those credits sit unworked while the patient either doesn't know or has to chase you down. 💰
The issue I see consistently isn't that credits aren't being posted correctly. It's that there's no defined workflow for what happens next.
Who runs the credit balance report? Who processes the refunds? By when? If you can't answer those questions, credits are accumulating right now.
This is not a bookkeeping inconvenience. Credit balances are a liability on your financial statements. They're a compliance risk with real teeth. ⚖️
And don't overlook this: every state has unclaimed property laws. 🏛️ Credits that sit long enough are legally considered abandoned property and must be turned over to the state.
Refunds should be processed as soon as they're identified; at minimum monthly.
That requires three things:
✅ A clear practice policy designating someone who owns the process
✅ A credit balance report that gets run and worked regularly
✅ A refund workflow that doesn't require the patient to ask
If any of those are missing, it's time to fix it.