Patient Payment Overpayments: A Hidden Revenue Cycle Gap

In doctor offices, clinics, and hospitals, staff often estimate patient responsibility for a billed medical procedure and collect that amount at the time of service. However, once the EOB is received, the actual patient responsibility is frequently lower, resulting in patient overpayments.

Most practice management systems — including RXNT — apply these overpayments to a patient credit balance, which may be used against future copays. However, the systems often do not correct the underlying HCPCS/CPT line by removing the overpayment.

The result?

-Amount paid per HCPCS line becomes slightly inflated — often by ~2% of total practice collections, which is material.

This can lead to:

-Inflated revenue forecasts

-Overstated accrued revenue

-Overpayment of physician bonuses when compensation is tied to collections

Unless corrected manually, the distortion compounds over time.
A key benefit of automation (like the solutions I build) is that it:

-Automatically corrects the HCPCS/CPT line when an overpayment occurs

-Matches the EOB and adjusts the patient’s chart to reflect what they should be billed for each visit (based on the most recent EOB patient responsibility)

-Prevents future overcharges by ensuring front-desk staff bill the patient correctly going forward

Small line-level inaccuracies add up — and quietly impact forecasting, cash flow, and compensation.

See post on Linkedin:

https://www.linkedin.com/posts/jeremiah-fuller-a09b2253_about-enhance-finance-now-get-started-activity-7426101311915466752-Iatz?utm_source=share&utm_medium=member_desktop&rcm=ACoAAAtg6SkBichtvhfDfch0kak-VJPMiM3ZgoU