Refunds to Providers

[Chell5]

I am currently paid by my provider by a percentage based rate.  If an insurance company recoups a payment for whatever reason, do I owe my percentage that I collected on that payment back to my provider?

[Michele]

We have had this come up a couple of times.  Usually it is not a large amount and it really wouldn't make a big difference.  However we have had a couple of situations where it was a larger retraction.  I will credit the provider back the % for my fee if the retraction was not the fault of the provider or if another insurance carrier is going to make payment.  However, if the retraction is due to an error in information given to me by the provider and there is no other insurance involved (and the provider gets paid by the patient) then I don't credit back my %. 

Sorry, not a straight answer but it actually depends on the situation.

Michele

[Pay_My_Claims]

Yeah..thats one of the cons for going for %..but its a way the provider knows you don't get paid until he gets paid.

[CasinosStorm]

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