Claim Issues: How to Record an Insurance Clawback or Reversal

Manual clawback entries let you record insurance payment reversals when a payer does not send an ERA. Use this workflow when you receive payment updates by phone, letter, or through a payer portal.

In this article:

• When to Use a Manual Clawback
• How to Record a Manual Clawback
• Frequently Asked Questions
• Related Resources

When to Use a Manual Clawback

Use a manual clawback when a payer notifies you of a payment reversal through non‑automated channels and no ERA is available. If an ERA reversal appears in your account, use the automated ERA workflow instead.

When you select the reversal option, Sessions Health:

• Creates a full reversing entry for the original payment
• Marks the original payment as reversed
• Adds a Needs Review flag to the claim
• Reopens the bill if the reversal creates a balance

How to Record a Manual Clawback

On a Claim

1. Open the claim under Insurance > Submitted Claims.
2. Select Add Manual Payment.
3. Select Reverse prior entry.
4. (Optional) Add details in the Source/Reason field.
5. Enter the updated payment or write‑off amounts.
6. Review the balance preview.
7. Select Save to process the reversal.

In Bulk Entry

Use this workflow when recording paper remittance sheets for multiple clients.

1. Go to Insurance > Payments.
2. Select the date of service with an existing payment.
3. Select Record Clawback for Existing Payment.
4. Enter the corrected payment amounts.
5. Select Save.

Editing a Manual Remittance Entry

1. Open the payment history in the claim or client ledger.
2. Select the manual payment entry.
3. Update the Insurance Paid, Write‑Off, Client Responsibility, or Insurance Responsibility fields.
4. Select Save.

Frequently Asked Questions

Why is there a Needs Review flag?

It reminds you to confirm the remaining balance and client responsibility before closing the claim. You can clear it from the claim overview.

What if I try to add a payment where one already exists?

A prompt appears offering the combined reversal and new payment workflow.

Does the system link the reversal to the original payment?

Yes. The reversal is linked to the original payment to maintain a complete audit trail.

Do manual clawbacks affect revenue reports?

Yes. Reversals and corrected payments appear as separate line items in all revenue reports.

Related Resources

For more billing tools that help you manage insurance payments and adjustments, see the resources below:

• Insurance FAQs
• Insurance: Remittance and Adding Insurance Payments
• Claims: Remittance (ERAs and manual remittance)
• Claim Issues: Common Denial Codes and How to Resolve Them
• Claim Issues: Problems with Claims and Enrollments