Skip to content

What To Do With Those Pesky Overpayments

Devery Johnson, Senior Business Consultant, FINEOS

All Claim Professionals strive to be diligent in knowing other sources of income a claimant may have which could affect their disability payments. The reality is, there are those situations where this knowledge comes after payments have been processed and the result is the infamous overpayment!

Here comes FINEOS to the rescue to make life easier for the staff delegated to recover these funds!

How much has been overpaid?

This was one of the more laborious, and mind-numbing tasks that I ever had to do as a claim professional, especially if the overpayment covered a large number of payments. While Excel made life easier, there was still work for someone to figure out all those calculations and get them into a user friendly format.

In FINEOS, by simply adding the offending offset (Worker’s Compensation, Social Security Disability Benefits, etc.) and the time frame to which it applies – FINEOS will automatically calculate the amount that has been overpaid – potentially saving hours of manual work!  This amount is then captured as a value to which all future recoveries are automatically applied, keeping all information in one place!

How Am I Getting My Money Back?

There are various ways to recover these amounts, and it’s best to have a policy in place or have a discussion with the legal folks before determining the best methodology for recovering.  However, the FINEOS application has many built-in options, which should satisfy the chosen methodology.

Recovery Plan

For those companies which choose an agreement between the claimant and the insurer regarding the amount to be deducted from future payments (this was our legal department’s preferred approach), you can set up a recovery plan. This will automatically deduct the agreed amount from future payments until such time as the overpayment has been exhausted.  Once all the money has been retrieved, the overpayment automatically shuts off and payments resume as normal.

If your company uses the services of a third party to recover overpayments, this is also accommodated by the application – to keep track of those payments as they are submitted, and automatically reduce the amount of the outstanding overpayment with each submission.

Actual Recovery

Occasionally, I would encounter the situation where the claimant wanted to repay with a single check (cheque for our Canadian and European friends! ).  To accommodate this situation, FINEOS has an option to apply these funds, and resolve the overpayment situation with one transaction.

Write-Offs

Sometimes the effort in recovering overpayments was not cost justified and to address this situation we took two approaches – we established an overpayment maximum that we would automatically write-off, or we would negotiate an amount that we would not pursue.

FINEOS can manage this situation as well, by using the overpayment adjustment feature. The amount that is not to be recovered is simply entered into the application. The other nice feature is that this option can be locked down by security, so only authorized users can apply written off amounts.

Help Is At Hand

So… the next time you are faced with that onerous overpayment scenario, don’t despair, FINEOS is here to help!