Reprocessed claim overpayment
The claim was reprocessed lower after the patient already paid.
The patient paid the original bill. A revised EOB later reduced the patient responsibility, creating a refund that the provider statement did not call out.
Original amount paid$312
Revised responsibility$165
Refund gap$147
What happened
1
The patient paid the first bill
The original EOB and provider statement led to a $312 payment that was recorded with the provider.
2
The insurer later reprocessed the claim
A revised EOB reduced the patient responsibility to $165 for the same service.
3
The overpayment was calculated
Insured Guard compared the payment record to the revised responsibility and surfaced a $147 refund opportunity.
When a claim is reprocessed downward, the refund does not always announce itself.
How do we know
It watches revised EOBs against prior payments.
The app treats reprocessed claims as new evidence and compares the revised patient responsibility to receipts already recorded. If the patient paid more than the updated amount, the difference is flagged as a refund candidate.