Author Topic: Persuing United Beh. Health overpayments  (Read 2825 times)

Buglet10

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Persuing United Beh. Health overpayments
« on: October 04, 2011, 03:14:38 PM »
I have 3 clients who have Medicare as primary and UBH as secondary.  I always electronically bill Medicare and then copy the eob when paid and send it with a HCFA to UBH.  They usually pay fine.  At the beginning of this year they paid all three of these clients as primary insurance even with the Medicare eobs and notes on HCFA second insurance!  I called and they said do not return the overpayment they will deduct it off future eobs.  This has only happened partially for one client.  I am ready to just return the money so my books balance (a little OCD yes!!)  anyway how long do you persue these companys  when it is their mistake.  If I find a mistake I always let them know or return the money with a letter. 

Michele

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Re: Persuing United Beh. Health overpayments
« Reply #1 on: October 05, 2011, 07:27:35 AM »
Personally we notify them and ask what they would like us to do (send a refund check or wait for them to retract, or whatever).  If they do not follow thru (if it's something they need to do) then we call back a second time.  If still nothing, we call back a third time.  Each conversation/interaction we have is well documented with who we spoke with and what we were advised.  After the third time, if the action is required on their end, we do not continue to follow up.  This is only if it is not a situation where we can mail a refund check.  If we are sure of the overpayment and know WHO gets the refund and the exact amount, then we advise the provider to mail the refund check (which they give to us and we mail with documentation).   The only case that we let it go is if we believe it was processed incorrectly, but are not sure of the exact outcome and need the insurance carrier to review the claim.  Or if the insurance carrier doesn't accept the refund check for whatever reason (which it has happened). 
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Buglet10

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Re: Persuing United Beh. Health overpayments
« Reply #2 on: October 06, 2011, 10:00:14 AM »
Thanks that's usually what I do - follow up a few times and document EVERYTHING.  They said don't send a refund check we will contact you so that's why I was wondering.  I personally prefer to just send the refund check but will see what their next step is.  Thanks again.

rdmoore2003

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Re: Persuing United Beh. Health overpayments
« Reply #3 on: October 06, 2011, 11:24:51 AM »
be very careful with UBH.   We used to take this insurance as out of network.   It is very difficult to get correct benefits.    Due to some problems we ended up just not accepting it at all for a couple of years.    This year we attempted to do credentialling with them.   Long story short, we contacted our area rep and was told that they did not credential for providers in a geographic area "unless there is a great need."   They went on to say that "UBH is in the business of their wellfare and not the welfare of the patients"    AGAIN BE CAREFUL!!!!!!
Regina

Sophrosyne

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Re: Persuing United Beh. Health overpayments
« Reply #4 on: October 11, 2011, 10:44:03 AM »
Does Medicare not automatically forward the claim to UBH after they process it? They ususally do for our Medicare patients with secondary insurance. If UBH is sending you a paper check that is incorrect, I'd send that straight back with a letter explaining and requesting proper payment (along with all pertinent EOBs of course). I HATE it when they deduct from future payments, what a bookkeeping mess! Our office has had so much trouble with UBH that all of our doctors have left the network. Not to mention the fact that they pay their contracted providers peanuts...  :P

rdmoore2003

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Re: Persuing United Beh. Health overpayments
« Reply #5 on: October 19, 2011, 02:05:31 PM »
medicare forwards to united healthcare but with them their mental health benefits are thru UBH.     
Regina

PMRNC

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Re: Persuing United Beh. Health overpayments
« Reply #6 on: October 25, 2011, 07:51:47 AM »
Quote
I am ready to just return the money so my books balance (a little OCD yes!!)  anyway how long do you persue these companys  when it is their mistake.  If I find a mistake I always let them know or return the money with a letter.

This is not OCD.. it's called the right way. Protects the audit trail!!  :) 

I must be in the minority because UBH is one of my favorites. I NEVER have a problem with them!!
Linda Walker
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