Medical Billing Forum

Payments => Patient Billing => Topic started by: Maci on December 15, 2010, 05:30:28 PM

Title: Refunding Copays
Post by: Maci on December 15, 2010, 05:30:28 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.
Title: Re: Refunding Copays
Post by: Michele on December 16, 2010, 06:41:30 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.

Title: Re: Refunding Copays
Post by: PMRNC on December 16, 2010, 08:31:20 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.