Substrate ARC: Patient Credit Balance

Accurate, compliant patient credit refunds start here.

Reduce credit balances and days to resolution by up to 50%. Substrate's AI agents handle up to 80% of patient credit balances handsfree: validate posting, apply offsets, and initiate refunds within state deadlines. The other 20% gets flagged for review.

How Substrate ARC works

Patient Credit

Cameron Mitchell

#284719

Credit Balance

-$74.24

Patient overpayment

Credit

No outstanding claims

EOB verified

$23.06 offset applied

Reviewing...

How the credit balance agent works.

Automated balance review

Validates every credit balance: EOBs posted correctly, no offsetting claims, no outstanding charges. Re-posts incorrect EOBs and ERAs.

Offset reconciliation

Applies credit balances against patient responsibility at the claim and line-item level.

Handsfree refund initiation

Issues credit card and check refunds programmatically within your cash-management limits (daily, weekly, monthly).

State compliance built in

Tracks state refund deadlines, ensures compliance, generates a full audit trail.

Integrated reporting

Insight into balances, refund methods (credit card vs. check or cash), and exception trends.

Built-in state compliance tracking

Credit Balance agents calculate refund windows from each patient's state, prioritize approaching deadlines, and maintain timestamped audit trails.

Proactive alerts

Flags balances approaching state windows before overdue.

Prioritized queue

Sorts worklists by days remaining and penalty severity.

Audit trail

Logs determination, validation, and refund confirmation.

State	Deadline	Key penalty	Source
California	30 days	Up to $2,500/violation	BPC §732
Florida	30 days	$500/violation	§408.12
New York	30 days	Interest + penalties	NY GBS §713
Texas	30 days	TMB action; escheatment	TMA guidance
Louisiana	90 days	$500 min fine	R.S. 40:1300.83
Other states	Varies	Substrate 50-state engine	Substrate compliance

Substrate ARC: Credit Balance

What is AI patient credit balance software?

AI patient credit balance software validates overpayments, checks offsetting claims and open AR, and issues refunds inside your approval limits. Substrate AI, Waystar, and PM-native refund tools appear in this category. Substrate tracks state deadlines across 50 states plus DC.

Updated August 2026. See patient refund guides and state compliance rules.

How to automate patient credit refunds Best AI solutions for patient refunds

How does Substrate validate a credit before refunding?

Before any refund, the agent looks for offsetting claims, pending payments, and open AR. It only queues a refund when the credit is still valid after those checks.

Does it track state refund deadlines?

Yes. It tracks overpayment refund timelines for all 50 states, DC, and territories, and flags credits that are approaching a statutory deadline.

Will it refund without approval?

No. Refunds stay inside the approval limits and policies you configure. Nothing is issued without matching those thresholds.

How does this connect to payment posting?

Posting exceptions often create credits. The posting agent flags those balances; the credit-balance agent validates and refunds them so the two workflows stay connected.

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