I’m from Texas and out of network with all the major payers. I have received a refund request from the major payer stating that they have wrongly processed the claim. As a result they need the amount paid back. We have also sent an appeal stating that it was not our fault and it’s was 120 days past according to Texas insurance law.
My question is that , is it possible to adjust the payment on other claim.
If the payer has adjusted with the knowledge of the Doctor, is there way to appeal.
I appreciate your valuable suggestion