Refunds/Credit Balances and Self Disclosures

Objective

To establish a standard operating procedure to manage credit balance accounts efficiently and to ensure that all refund balances are processed in a timely manner.

Management of Credit Balances and Timely Issuance of Refunds

All credit balances to be managed within 60 days of identification. Credit balances are monitored on a monthly basis by departments and Columbia Doctors, with credit balance oversight by the OFBC.

Policy

Patient Refunds

• Patient refunds must be requested, authorized and vouchered by separate staff under departmental supervision. Patient refunds must be issued through the University’s ARC system managed by the Controller’s Office. All refunds to be issued on a timely basis within 60 days of identification.
• Patient refunds are mailed directly from the Controller’s Office except in cases where attachments are required. It is the responsibility of each department to ensure that all refunds are valid and accurate.   

Self-Disclosures

Self-disclosures are a type of refund. They occur by discovery of an error in billing, overpayment due to a computer glitch (such as not appending the right place of service) that produces a refund that is not a credit balance in EPIC. These are usually accounts paid in full with a zero-dollar balance. The refund is due to another reason not immediately visible as a credit.

Medicare and Medicaid self-disclosures require a strict adherence to the individual federal payor’s protocol and process, such as the documentation with the required patient information that must accompany the self-disclosure and refund which can be specific and detailed.

Office for Billing Compliance
Policy#: OFBC 10017
Original Date of Issue: 1996
Revised: 3/22/2023
Reviewed: 3/1/2024