> ## Documentation Index
> Fetch the complete documentation index at: https://help.clinikehr.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Write off an HMO balance

> Write off what an HMO will not pay, with a reason, and decide whether a second person must approve larger write-offs.

export const InsuranceRegion = ({region}) => {
  const us = region === 'us';
  return <div className="ck-avail" role="note" aria-label="Which insurance setup this page is for">
      <span className="ck-avail__label">Insurance</span>
      <span className="ck-pill ck-pill--plan">{INSURANCE_REGION_LABELS[region] || region}</span>
      <span className="ck-avail__note">
        {us ? 'For clinics whose owner chose United States (US insurance claims) under Settings → General → Insurance: electronic claims to US payers, eligibility checks and insurer remittance. ' : 'For clinics whose owner chose Outside the US (HMO and international insurers) under Settings → General → Insurance: HMOs, the claims register, pre-authorization and HMO payments. '}
        {us ? <a href="/hospital/insurance/claims">Outside the US? See the HMO and international insurance pages.</a> : <a href="/practice/money/insurance-claims">In the United States? See US insurance claims.</a>}
      </span>
    </div>;
};

export const StillStuck = ({topic}) => <div className="ck-callout ck-callout--note" role="note">
    <p className="ck-callout__body">
      <strong>Still stuck{topic ? ` with ${topic}` : ''}?</strong>{' '}
      Check <a href="/platform/help/troubleshooting">Troubleshooting</a> first —
      it covers the failures we see most often. If that does not resolve it,{' '}
      <a href="/platform/help/contact-support">contact support</a> and include
      your workspace name and the time the problem happened, so we can find the
      matching entry in your audit log.
    </p>
  </div>;

export const TaskHeader = ({before, time, after}) => <div className="ck-task">
    {before ? <div className="ck-task__cell">
        <div className="ck-task__title">Before you start</div>
        <p className="ck-task__body">{before}</p>
      </div> : null}

    {time ? <div className="ck-task__cell">
        <div className="ck-task__title">Takes about</div>
        <p className="ck-task__body">{time}</p>
      </div> : null}

    {after ? <div className="ck-task__cell">
        <div className="ck-task__title">When you're done</div>
        <p className="ck-task__body">{after}</p>
      </div> : null}
  </div>;

export const Path = ({steps = []}) => <span className="ck-path">
    {steps.map((s, i) => <span key={i} className="ck-path__step">
        {i > 0 ? <span className="ck-path__sep" aria-hidden="true">
            ›
          </span> : null}
        {s}
      </span>)}
  </span>;

export const Availability = ({editions = ['all'], plans, roles, note}) => {
  const list = editions.includes('all') ? ['clinic', 'pharmacy', 'lims'] : editions;
  return <div className="ck-avail" role="note" aria-label="Feature availability">
      <span className="ck-avail__label">Available in</span>

      {list.map(e => <span key={e} className={`ck-pill ck-pill--${e}`}>
          {EDITION_LABELS[e] || e}
        </span>)}

      {plans ? <span className="ck-avail__label">Plan</span> : null}
      {plans ? <span className="ck-pill ck-pill--plan">{plans}</span> : null}

      {roles ? <span className="ck-avail__label">Who</span> : null}
      {roles ? <span className="ck-pill ck-pill--role">{roles}</span> : null}

      {note ? <span className="ck-avail__note">{note}</span> : null}
    </div>;
};

<Availability editions={['clinic']} plans="Enterprise" roles="Owners and managers" note="Needs the Insurance care area switched on, and Settings → General → Insurance set to Outside the US." />

<InsuranceRegion region="non_us" />

Sometimes an HMO rejects a line for good. A **write-off** closes what it will not pay so the claim stops showing as owed. It is permanent, it needs a reason, and it is recorded against the person who made it.

<Path steps={['Sidebar', 'Insurance', 'Claims', 'HMO receivables']} />

<TaskHeader before="A submitted claim with a balance the HMO has refused" time="1 minute" after="The balance no longer shown as owed, with the reason on record" />

## Write off a balance

<Steps>
  <Step title="Open the claim's balance">
    On **HMO receivables**, select **View claims** for the insurer, then **Write off** beside the claim. You can also choose **Write off balance** from a claim's **Actions** menu.
  </Step>

  <Step title="Enter the amount and the reason">
    **Amount to write off** starts at what is owed; you can write off less. **Reason** is required — say why it will not be collected.
  </Step>

  <Step title="Confirm">
    Select **Write off**. You are told **Written off** and the balance is reduced at once — unless your hospital asks for a second person to approve it, below.
  </Step>
</Steps>

You cannot write off more than the insurer owes. A claim with a write-off already waiting for approval cannot take a payment or another write-off until it is decided.

## Ask for a second approval above an amount

By default the person who may write off a balance does it on their own. To make larger ones wait for someone else, an owner or manager opens **Approving write-offs** on **HMO receivables**, switches on **Require a second person for larger write-offs** and sets **Needs approval above**. A write-off up to that amount still applies at once; above it, the button reads **Send for approval**.

A waiting write-off **changes nothing** on the claim. It appears under **Write-offs** as **Waiting for approval**. A person who may approve it, and who is **not the person who asked**, sees **Approve** and **Refuse**:

* **Approve** applies the write-off. It cannot be undone. If the claim's balance has changed since the request, you are told and the request must be refused and asked again.
* **Refuse** leaves the claim as it was.

You can add a note to either.

## Who can do this

| Action | Who by default | The permission |
| - | - | - |
| Write off, or ask to write off | Owners, managers | **Write off HMO balances** |
| Approve or refuse | Owners, managers | **Approve HMO write-offs** |
| Turn second approval on or off, set the amount | Owners, managers | — |

Both permissions are off for everyone else until an owner switches them on for a person in their [Permissions](/platform/team/permissions) sheet. The person who asks can never be the person who approves.

## Check it worked

* The claim reads **Paid** or **Part paid** with the written-off amount no longer owed — or **Written off** if nothing was paid.
* Under **Write-offs**, the request reads **Written off**, with your reason.

## Common issues

<AccordionGroup>
  <Accordion title="Write off is not offered">
    You may not have the permission, or the claim is not submitted, is denied or is already settled.
  </Accordion>

  <Accordion title="I asked for a write-off and nothing changed">
    It is waiting for a second person to approve it. It will show **Waiting for approval** under **Write-offs**.
  </Accordion>

  <Accordion title="Approve is missing on my own request">
    A different person must approve it. Ask another owner, manager or person who has been given **Approve HMO write-offs**.
  </Accordion>
</AccordionGroup>

<StillStuck topic="a write-off" />


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