Insurance overpayment

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15-Jul-2013 10:12 AM

ILoveAcupuncture

Posts: 35

What is the correct way to handle an overpayment by insurance? Originally I was told a patient had to pay 20%, so on her $50 bill, she paid $10, and I marked the appropriate boxes on the HCFA form. Then I found out after submitting it to her insurance that she had already met her out of pocket maximum for the year, so she is covered 100%.

 

So insurance now paid me the full $50 (plus I have the $10 that the patient paid). So do I just write a check to the patient to reimburse her the $10, or do I have to contact the insurance company to resubmit two checks – $10 to her, and $40 to me?  Thanks!


 

15-Jul-2013 04:06 PM

Matthew Bauer

Posts: 211

Write a check for the refund if the insurance is paying your whole fee. Just make sure you have a line for refunds in your tax records and you account for that there. When we have someone who ends-up paying some co-pay, we usually will ask them if they want us to credit them the refund amount and then subtract their co-pay from that credit. Most will have us do that.

Matthew Bauer
 

16-Jul-2013 09:14 AM

ILoveAcupuncture

Posts: 35

That helps – thank you!