Medical Billing Forum

Payments => Patient Billing => : Maci December 15, 2010, 08:30:28 PM

: Refunding Copays
: Maci December 15, 2010, 08:30:28 PM
I have two billing managers one states that we have to refund copays if claims are denied due to untimely filing. On the hand I am been told that no we do not refund because services where rendered and patient was responsible for paying copay. So far neither has been able to prove in black & white Any suggestion with this would be great, by the way we are in California.
: Re: Refunding Copays
: Michele December 16, 2010, 09:41:30 AM
Usually the contract between the provider and the insurance carrier will state that the patient cannot be charged for copays/coinsurance if the provider does not follow thru on their end of the claim (timely filing, authorization obtained, etc.).

I would suggest looking at the contracts.

Michele
: Re: Refunding Copays
: PMRNC December 16, 2010, 11:31:20 AM
I agree with Michelle you have to look at contracts. I have seen contracts where the patient is responsible for copay's with the only stipulation that the services were rendered.