ASO Policies and Procedures
Recoupment Processing in STAR
When a service or claim is submitted for payment that should not have been processed, or the circumstances of the rendered service have changed since it was approved, those services can be processed for recoupment in STAR. Recoupments can only be processed for Open Fiscal Years.
Requesting a Recoupment
To request a recoupment, please reach out to Falling Colors Support (support@fallingcolors.com) with the following information:
Service Recoupments:
The Transaction ID of the Service.
The Invoice ID of the Service.
The Amount to be recouped:
Partial recoupments: if the amount to be recouped is a partial amount of the full service amount, indicate the distinct amount needing to be recouped.
Full recoupment: if the amount to be recouped is the entirety of the service, indicate it is a full recoupment.
Invoice Recoupments:
The relevant Invoice ID.
The Amount to be recouped:
Partial recoupments: if the amount to be recouped is a partial amount of the full service amount, indicate the distinct amount needing to be recouped.
Full recoupment: if the amount to be recouped is the entirety of the service, indicate it is a full recoupment.
Claim Recoupment:
The relevant Claim ID(s).
Claims can only be scheduled for full recoupments.
Falling Colors is unable to process recoupments for transactions/invoices/claims that are outside of the current/open Fiscal Year(s).
Recoupment Processing
Once the Falling Colors Support Team has received sufficient information for a recoupment request, we will process the recoupment in STAR.
Falling Colors Support will review and confirm that the requested transaction falls within the open Fiscal Year(s).
Falling Colors Support will submit the transaction for recoupment.
Falling Colors Support will schedule the recoupment for repayment via a Payment Reduction against future/pending services.
Falling Colors Support will relay to the requestor that the transaction has been scheduled for recoupment.
Finalizing the Recoupment
Recoupments can only be finalized once the amount of the transaction has been accounted for. This can be accomplished by:
Payment Reduction:
The Payment Reduction process in STAR reduces any future payments to the provider by the amount of the scheduled recoupment, such that the provider submit an invoice that is greater than or equal to the amount needing recoupment.
This serves to benefit the provider so that they do not have to send back the recoupment amount when they will continue to render services and receive payment through STAR.
These amounts can be accounted for on the Payment Detail report.
Example:
Recoupment Amount: $200
Provider’s Next Invoice Amount: $500
Payment Provider will Receive: $300
In order to process the recoupment, the Provider’s Next Invoice Amount must be greater than or equal to the Recoupment Amount.
Recoupment via Check:
Falling Colors will only accept checks for recoupment for the following situations:
A provider has no remaining funding to account for the overage.
The corresponding Lead Agency is closing out their Fiscal Year.
Please see our guide for Recoupment by Paper Check for more information.
Recoupments outside of a Fiscal Year:
If you have identified a recoupment that is necessary outside of a closed fiscal year, please contact the relevant Lead Agency, as identified below. You will then direct a physical check to one of the following:
Children’s Youth and Families Department- Administrative Services Division/CYFD
Attn: Bobby Trujillo
1120 Paseo de Peralta,
Santa Fe, NM 87501
Human Services Department/BHSD
Attn: Steve Roybal
PO Box 2348
Santa Fe, NM 87504-2348