Payments > Patient Billing

Refunding Copays

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Maci:
I have two billing managers one states that we have to refund copays if claims are denied due to untimely filing. On the hand I am been told that no we do not refund because services where rendered and patient was responsible for paying copay. So far neither has been able to prove in black & white Any suggestion with this would be great, by the way we are in California.

Michele:
Usually the contract between the provider and the insurance carrier will state that the patient cannot be charged for copays/coinsurance if the provider does not follow thru on their end of the claim (timely filing, authorization obtained, etc.).

I would suggest looking at the contracts.

Michele

PMRNC:
I agree with Michelle you have to look at contracts. I have seen contracts where the patient is responsible for copay's with the only stipulation that the services were rendered. 

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