Author Topic: Refunds  (Read 1979 times)

mruiz12

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Refunds
« on: August 28, 2009, 01:39:34 PM »
I know that i have asked this question before, but i just need to clairify something. I am working on aging account from 2004 that have patient credits and insurance credit. I just e-mailed one of my insurance to ask them to reproces and old claim from 2005 becasue they paid as primary when they were secondary at the time. I asked them to request the refund back from me requesting the correct dollar amount. They wrote back and stated that they cannot reprocess claims that are 4 years and older assembly law ab1455. So what do i do with this credit balance on my account for health insruance that are this old can i write these off. I am confused i know i still have to refund the patients that have credit balances but what about Health insurance. Can someone please help! I called this insurance to call back to see what they want me to do with the credit balance no one has called back. :o

Pay_My_Claims

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Re: Refunds
« Reply #1 on: August 28, 2009, 01:42:02 PM »
I will send you my PO box number to send me the check :-)

PMRNC

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Re: Refunds
« Reply #2 on: August 28, 2009, 05:25:43 PM »
What I usually do is document the patient's file, If it's a credit to the carrier I have the provider refund it with an explanation (their problem on re-processing). Another thing you could do is create another database and add your credit balances there this way if the carrier does come knocking on the door you have the claims in there but not in your A/R.
I do try and just refund the carriers though to get it out of our hair.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Michele

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Re: Refunds
« Reply #3 on: August 28, 2009, 07:10:21 PM »
I agree with Linda.  If you send them the refund with the request to reprocess it is their problem.  Then if they want to return the check because they can't reprocess fine, at least the refund was sent in.

Michele
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nparianous

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Re: Refunds
« Reply #4 on: September 23, 2009, 07:00:22 AM »
Pay my claims, you are soooo funny!!!!   I love reading your responses, who needs the daily comics!!!!     

MBP

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Re: Refunds
« Reply #5 on: September 23, 2009, 08:13:04 AM »
I agree, Pay My Claims you brighten our days!  ;D

oneround

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Re: Refunds
« Reply #6 on: October 23, 2009, 05:47:35 PM »
When I used to work our esheatments we would contact the payors if the payor indicated that they could not retor on their claims we did what we called a 'Good Faith' effort and were allowed to keep the monies.
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

PMRNC

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Re: Refunds
« Reply #7 on: October 24, 2009, 04:02:16 PM »
There is a lot of controversy over refunds from carriers.. Carriers have written policies that allow them to request refunds but there are some situations they can't.. usually those are situations where by paying the claim has set a "precedence". If you have a patient who's claims were first paid but later the carrier says, the patient terminated and they wanted the money back, they are entitled to that money, there's lots of reason their system didn't pick up the termination date (COBRA, etc)  Each situation has to be evaluated.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com