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What to do with Insurance overpayment?

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BalancedLiving:
I am currently billing insurance companies for my husband's new chiropractic office. I am very careful and thorough, as I am scared of making mistakes that could cost us. Aetna recently paid on visits for a patient who had reached his yearly benefit max for Chiropractic. (They paid $82.50 over his plan benefits) At first I thought there was no harm in billing and seeing if they'd pay, as maybe our visit numbers were not accurate, due to him seeing another doc previous to care in our office.  Now I'm wondering if this could get me in trouble? Do I need to send this back to them somehow? Advice would be appreciated!

BalancedLiving:
Are insurance overpayments really that unusual? 8 reads and no replies. Hmm. Just wondering if insurance companies state anywhere what the protocol is for overpayments? No one knows?

PMRNC:
The carriers have their own protocol's but ultimately if you know they overpaid the correct and legal responsibility is to return the payment with explanation, if not they can recoup for the time limit allowed (state laws on this now)   Some carriers will process the future claims and deduct the overpayment there and some will just request it.

DMK:
I hesitated to respond to this because each carrier is going to handle it differently. 

With Aetna, my experience has been that they don't include exam codes in the chiropractic $ amount allowed.  That may explain some of it. 

Medicare, don't mess with, send it back.

Blue Cross will find it, so beat them to it.

Always re-pay W/C.

The best advice I've seen is to call!  They'll let you know if it was correctly paid.

BalancedLiving:
Thankyou PMRNC! I'll just contact them and ask how to send it back then. Would you normally not even bill to "see if they'll pay" if it's suspected that the benefits max has been met?

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