Problem Statement

Patient credit balances have to be reviewed and resolved through refund or adjustment, and working them manually is slow; unresolved credits sit on accounts, create compliance exposure, and tie up money owed back to patients. A self-pay credit shouldn't always be refunded outright: it may need to be applied against the patient's other open balances first, with adjustments made before any refund. Checking each credit across hospital and professional billing by hand is detailed work, and a credit handled wrong either refunds money still owed elsewhere or leaves a balance uncleared.

Automation Solution

This automation checks self-pay credits in Epic and Trust Commerce for refund eligibility, applies them to outstanding balances, and processes any necessary adjustments before submitting a refund request.