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.

1 Requesting a Recoupment
- 1.1 Service Recoupments:
- 1.2 Invoice Recoupments:
- 1.3 Claim Recoupment:
2 Recoupment Processing
3 Finalizing the Recoupment
- 3.1 Payment Reduction:

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:
1. 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.
2. 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:
1. 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.
2. 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.

Recoupment via Check:

Falling Colors will 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.
The provider is solely configured for Check payments and does not have an EFT configuration.

Please see our guide for Recoupment by Paper Check for more information.