But if the patient hasn't met their Medicare deductible, and if they don't have a secondary or supplemental, OR they bill correctly with the correct modifiers for the services performed (covered vs. non-covered) at least the patient has paid toward the anticipated patient portion. I understand they will absolutely have to refund the monies the patient does not owe.
I also see your point regarding an immediate refund, but sometimes it's hard to get the patient to pay the 1st time, let alone a second time! JMO.