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
Navigate to Insurance > Submitted Claims, open the claim, and select the Remittance tab.
- Select Add Remittance.
- Select Continue on the Payment Already Exists prompt.
- Select the Reverse prior entry check box.
- (Optional) Enter a reason for the reversal in the Reason for reversal field.
- (Optional) Enter new Insurance Paid or Write‑Off amounts.
- Select Save.
- Select Confirm to finalize the reversal.
In Bulk Entry
Use this workflow when recording paper remittance sheets for multiple clients.
- Go to Insurance > Payments.
- Select + Add to open the bulk entry table.
- Select the check box next to the date of service with an existing payment.
- Select Record Clawback for Existing Payment.
- Enter the corrected payment amounts.
- Select Save.
Editing a Manual Remittance Entry From a Claim
Use this workflow to correct a manual remittance entry that has already been saved.
- Open the claim under Insurance > Submitted Claims and select the Remittance tab.
- Select the manual remittance row to open the editor.
- Update the Client Owes, Insurance Paid, or Write‑Off fields.
- Select Save.
Editing a Manual Remittance Entry From the Insurance Tab
You can also follow these steps to correct a manual remittance.
- Go to Insurance > Payments.
- Select View next to the specific payment row.
- Select the manual remittance entry you need to adjust.
- Update the Client Owes, Insurance Paid, or Write-Off fields.
- 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: