Wiki Refunding Patient Payment Credits Laws

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Can someone direct me to where I can find the exact laws/guidelines on the requirements of refunding patients when they overpay on their accounts. We are looking for the information to provide to our providers with regards to the time frame with which they have to issue the refund, and if there is a minimum dollar amount that does not have to be refunded for say a small balance (like under $10), or that does not have to be turned over to the state as unclaimed property due to being under a certain amount. Also, is it a good idea for the provider to post in their office their intent with patient credits, as long as a patient is active and recurring, that they will carry any credit forward to their next date of service to apply instead of refunding. If someone can direct me to where I can find this information in writing that would be greatly appreciated.
 
What state?

California:
Business and Professions Code-BPC
Division 2. Healing Arts, Chapter 1. General Provisions, Article 10.5 Unprofessional Conduct

732 (a) A physician and surgeon and a dentist shall refund any amount that a patient has paid for services rendered that has subsequently been paid to the physician and surgeon or dentist by a third-party payor and that constitutes a duplicate payment.  The refund shall be made as follows:
(1) If the patient requests a refund, within 30 days following the request from that patient for a refund if the duplicate payment has been received, or within 30 days of receipt of the duplicate payment if the duplicate payment has not been received.
(2) If the patient does not request a refund, within 90 days of the date the physician and surgeon or dentist knows, or should have known, of the receipt of the duplicate payment, the physician and surgeon or dentist shall notify the patient of the duplicate payment, and the duplicate payment shall be refunded within 30 days unless the patient requests that a credit balance be retained.
(b) Violation of this section shall constitute unprofessional conduct.  Disciplinary proceedings shall be conducted in accordance with the Medical Practice Act ... or the Dental Practice Act ... as applicable.
effective January 1, 1994.


Edited to add: Unclaimed property is when you cannot find the patient/person you owe money to, and you should contact your state's Unclaimed Property Division for specifics on minimums.
 
Last edited:
What state?

California:
Business and Professions Code-BPC
Division 2. Healing Arts, Chapter 1. General Provisions, Article 10.5 Unprofessional Conduct

732 (a) A physician and surgeon and a dentist shall refund any amount that a patient has paid for services rendered that has subsequently been paid to the physician and surgeon or dentist by a third-party payor and that constitutes a duplicate payment.  The refund shall be made as follows:
(1) If the patient requests a refund, within 30 days following the request from that patient for a refund if the duplicate payment has been received, or within 30 days of receipt of the duplicate payment if the duplicate payment has not been received.
(2) If the patient does not request a refund, within 90 days of the date the physician and surgeon or dentist knows, or should have known, of the receipt of the duplicate payment, the physician and surgeon or dentist shall notify the patient of the duplicate payment, and the duplicate payment shall be refunded within 30 days unless the patient requests that a credit balance be retained.
(b) Violation of this section shall constitute unprofessional conduct.  Disciplinary proceedings shall be conducted in accordance with the Medical Practice Act ... or the Dental Practice Act ... as applicable.
effective January 1, 1994.


Edited to add: Unclaimed property is when you cannot find the patient/person you owe money to, and you should contact your state's Unclaimed Property Division for specifics on minimums.
Sharon,

Thank you for sharing this information. Do you have a link/s for the above information?

Wendy
 
Sharon,

Thank you for sharing this information. Do you have a link/s for the above information?

Wendy

California Legislation Information (all laws): https://leginfo.legislature.ca.gov/faces/codes.xhtml

Business and Professions, Healing Arts: https://leginfo.legislature.ca.gov/...PC&division=2.&title=&part=&chapter=&article=

Section 10.5, Unprofessional conduct (scroll down to section 732): https://leginfo.legislature.ca.gov/...ision=2.&title=&part=&chapter=1.&article=10.5.
 
I actually have the same question. I live in Connecticut. Can anyone help me find the laws for Unapplied credit for patients. Thank you
 
I started a new job.. their UAC credit for insurance and patients is beyond horrible. I am trying to find laws to help my drs understand this needs to be fixed. I am feeling lost!!
 
If nothing else, it's unethical to keep someone's money if they overpaid. Especially if it's in the hundreds of dollars. That's just my viewpoint. I recently was able to work our patient aging report and was able to refund tens of thousands of dollars back to patients. This report hadn't been worked in a very long time. It was embarrassing.
 
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