Medical Billing Forum

General Category => General Questions => Topic started by: barb2512 on October 19, 2012, 09:47:45 PM

Title: Provider owes the client a large refund
Post by: barb2512 on October 19, 2012, 09:47:45 PM
I help a counselor remotely. Working on his web based program, filing claims and following up, entering insurance payments and charging client's credit cards in the same web program for their copays. Provider had an outside billing service until August 15th of this year. While he had the billing service I did alot of his office work, contacting and coordinating care with other doctors, setting up client's ERA files, credentialing, and charging client's credit cards for their copays.

Today a client called that her credit card had  been charged outrageously over the last couple of months. The provider and I went over the account and we went back to the client's first visit and reconstructed what was owed and what was charged.

Due to problems with our former billing company and the amount they reported to us that the client would owe for the copay for weekly counseling, which proved to be erroneous, and the web based software we were using that wasn't holding the charges to the date of service, so that I charged a date of service more than once because I could not see that I had already charged the copay, well, the provider now owes the client nearly $500 in overcharges.

The client is sick about the overdraft fees she has to pay. The counselor is sick about repaying the money and the overdraft fees with his financials strapped because his partner was laid off this summer. And I am sick that I made such an error of too many charges.

Once I do something my brain does not remember the details. I can handle detailed work but once it is done, my mind moves on.

But I am sick about this error. There were a lot of pieces in play but I do feel like I dropped the ball at times.

Anyway, So far, the counselor still wants to keep me on, feeling like we muddle through together.

I told him to consult a lawyer before he gives her a refund just to be sure he is saying and doing things the right way. We went back to visit #1. We did not just start at the point where the client had a question. He is going to call his malpractice insurance before he speaks to the client.

I am going to have a glass of wine and hope this is the only client that we have over charged.

Comments and insights welcome.

Title: Re: Provider owes the client a large refund
Post by: PMRNC on October 20, 2012, 07:47:07 AM
First of all we all make mistakes. I give you a LOT of credit for owning your part in the error, we don't see enough of that :)   Big question.. Are you an "employee" or are you under contract as a business or subcontractor?   If you are an employee, does the provider have a policies and procedures, THAT is the first place you go with situations like that. If he doesn't then he needs to get one together ASAP!!  If you are a billing company you too should have policies/procedures and compliance plan to consult for situations such as this.   After that take a deep breath and try to learn from each mistake, it won't be the last one. :)
Title: Re: Provider owes the client a large refund
Post by: barb2512 on October 25, 2012, 10:59:17 AM
Thank you for your reply. I guess I work as a contractor. I work remotely and receive a 1099. I pay my own taxes.

The counselor has been great about it. And the client has been great too.

I think I fall in a grey zone. I don't know whether to call my self a contract employee or go full out as a billing service. I need to explore the advantages of both. And the disadvantages too!

Thank you.
Title: Re: Provider owes the client a large refund
Post by: PMRNC on October 25, 2012, 11:23:03 AM
Either way, Contractor or Business you want to make sure you have Errors and Omissions or business liability/malpractice insurance and make sure you have a good contract with your provider.