Medical Billing Forum

General Category => General Questions => Topic started by: ChiroPay on January 21, 2009, 02:56:59 PM

Title: Regarding Refund request
Post by: ChiroPay on January 21, 2009, 02:56:59 PM
Iím from Texas and out of network with all the major payers. I have received a refund request from the major payer stating that they have wrongly processed the claim. As a result they need the amount paid back. We have also sent an appeal stating that it was not our fault and itís was 120 days past according to Texas insurance law.

My question is that  , is it possible to adjust the payment on other claim.
If the payer has adjusted with the knowledge of the Doctor, is there way to appeal.
I appreciate your valuable suggestion
Title: Re: Regarding Refund request
Post by: Michele on January 22, 2009, 06:40:35 AM
'My question is that  , is it possible to adjust the payment on other claim. '

Are you asking if it is possible for them to take the overpayment from a future claim or are you asking if it is ok for them to go back now and adjust the old claim and ask for the money back?

Some insurance carriers will take overpayments from future claims but it depends on their policy.

You can certainly appeal their request for the overpayment depending on the circumstances.  You would just send in a written explanation of your objections and attach a copy of the request for the refund.

Good luck.
Michele