Author Topic: Keep or return insurance payments?  (Read 145 times)

orbsphere

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Keep or return insurance payments?
« on: December 18, 2017, 01:06:11 PM »
An out of network doctor attended ER surgery. A year later still no bill but insurance company sent me checks to pay doctor's claim (i explained circumstances to ins. co. and they agreed to pay). Can I keep the money paid me if I don't receive a bill from doctor? I've talked via phone to the doctor himself several times and he says secretary will call but never has.

Michele

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Re: Keep or return insurance payments?
« Reply #1 on: December 19, 2017, 08:57:34 AM »
You could send the checks to the provider without a bill, but personally I would not be comfortable with that.  You can cash the checks, but just know that some day you may receive a bill.  Laws vary from state to state on how long a provider has to bill a patient.  IMO you have done what you can and notified the provider and tried to get the money to him.  Bottom line the services were performed, the insurance paid you because the provider is not in network.  You are responsible for the bill, when and if it comes but in the meantime I would cash the checks before they become VOID.
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PMRNC

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Re: Keep or return insurance payments?
« Reply #2 on: December 19, 2017, 11:08:44 AM »
IF you cash the checks, you should send payment to the servicing provider/facility, If you don't do that it could be considered theft of service. Just because you didn't get a bill doesn't mean they didn't send one. IMHO the best way to handle this is to contact them and endorse the checks and send to them with a copy of the EOB. That is the safest way to go.
Linda Walker
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orbsphere

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Re: Keep or return insurance payments?
« Reply #3 on: December 19, 2017, 12:18:41 PM »
Thanks all.... I did deposit checks thinking a bill would be arriving soon and money would be in account ready for payment. Endorsement would have worked great had I known I might not get a bill up front. Of course I'd have to hunt down an address for where to send as I did do to get phone number.... I was thinking along lines of auto ins., get estimate, ins. sends me check, I can have repair work done or pocket the cash. Hadn't consider that services were already performed. Good point.... ER surgeon must have requested doc. to attend.... As I mentioned I called doc. several times, seeded grateful I called first couple times but not so much during later calls, maybe wasn't free to talk (on rounds or something).... Had to Google his number each time but last time I noticed his address is close by. Now if I can catch him in his office (I'm wondering when he says "secretary will call" if that means he'll get back to me when he gets in the office (then forgets?).... I'll definitely see to it he gets paid.

Michele

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Re: Keep or return insurance payments?
« Reply #4 on: December 20, 2017, 09:02:56 AM »
I agree with Linda, however, the fact that you've already gone through so much effort to attempt to get the provider the money had me thinking I would now sit and wait.  But Linda has a good point, the services were performed.  I'm not a legal expert but to me it seems like it couldn't be theft of services since you aren't disputing the bill or refusing to pay you are simply waiting for information on where to send the payment.  Maybe another phone call?
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PMRNC

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Re: Keep or return insurance payments?
« Reply #5 on: December 28, 2017, 03:10:17 PM »
I would have started by calling the insurance company and asking who the rendering provider was, when they got the bill they had the name/address and of course Tax ID :)
Linda Walker
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www.billerswebsite.com