Go Back   AAPC Medical Coding & Billing Forums > Practice Management > General Discussion
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools
  #1  
Old 03-15-2012, 09:13 AM
jthweatt jthweatt is offline
Networker
 
Join Date: Apr 2007
Location: Tuscaloosa, AL
Posts: 92
jthweatt is on a distinguished road
Default Refunding Patient Overpayments

Is anyone willing to share their office policy on refunding patients? I am aware of the time limit for Medicare/ Medicaid, but want to know how quickly you refund patient overpayments. Do you have a minimum overpayment before you issue a refund? Do you require the patient pick up the check? Or do you mail it?

Thanks.
__________________
Jerri, CPC
Reply With Quote
  #2  
Old 03-15-2012, 09:39 AM
penguins11 penguins11 is offline
Expert
 
Join Date: Apr 2007
Posts: 264
penguins11 is on a distinguished road
Default

Our office manager does patient overpayment refunds 2x a month on Fridays and we mail the payment back to the patient. We do not have a minimum. If the patient is coming back in then we generally call the patient and tell them that a refund will be waiting for them at the front desk or ask them if they would like to apply the overpayment to a copay if you know one is going to be due.
Reply With Quote
  #3  
Old 03-15-2012, 10:00 AM
Tracey Thompson Tracey Thompson is offline
Guru
 
Join Date: Apr 2007
Posts: 114
Tracey Thompson is on a distinguished road
Default Medicare / Medicaid

Can you elaborate on the time limits for Medicare / Medicaid?

Thanks!
__________________
Tracey Thompson, CPC, CPPM
Reply With Quote
  #4  
Old 03-29-2012, 08:04 PM
ckkohler ckkohler is offline
Guru
 
Join Date: Apr 2007
Location: Omaha, Nebraska
Posts: 124
ckkohler is on a distinguished road
Default

I am not aware of any time frame requirement by Medicare or Medicaid - but, in our office .. we have implemented the practice that any overpayments greater than $100 automatically get a refund (unless there is a specific reason they have such a large credit); by this, I mean - we have some patients that have $5,000 annual deductibles so to offset that - they pay $100 per month ... of course if ever a patient calls about an overpayment of any amount then we automatically process; for overpayments less than $100 ... I review their appointment history to see if they will be coming back - we are a pain management specialty clinic .. so, some return on a regular basis and sme return as needed ... hope this helps!
__________________
Carolyn Kohler, CPC
Omaha, NE
Reply With Quote
  #5  
Old 03-30-2012, 06:46 AM
dclark7 dclark7 is offline
True Blue
 
Join Date: Apr 2007
Location: Hartford, CT
Posts: 513
dclark7 will become famous soon enough
Default

According to the Affordable Care Act, providers have 60 days after they become aware of an overpayment to refund the money. If the overpayment is not refunded within that time period it can be considered a false claim. This is copied from the ACA:
SEC. 6402. ENHANCED MEDICARE AND MEDICAID PROGRAM INTEGRITY
PROVISIONS.
(d
) REPORTING AND RETURNING OF OVERPAYMENTS.—

(1) IN GENERAL.—If a person has received an overpayment,
the person shall—
(A) report and return the overpayment to the Secretary,
the State, an intermediary, a carrier, or a contractor,
as appropriate, at the correct address; and
(B) notify the Secretary, State, intermediary, carrier,
or contractor to whom the overpayment was returned in
writing of the reason for the overpayment.
(2) DEADLINE FOR REPORTING AND RETURNING OVERPAYMENTS.—
An overpayment must be reported and returned under
paragraph (1) by the later of—
(A) the date which is 60 days after the date on which
the overpayment was identified; or
(B) the date any corresponding cost report is due,
if applicable.
__________________
Doreen Clark, CPC, CPMA
Medical Auditing Specialist
Integrated Physicians Management Services
East Harftord. Ct
Reply With Quote
  #6  
Old 04-06-2012, 11:39 AM
dflieger dflieger is offline
Networker
 
Join Date: Apr 2007
Posts: 45
dflieger is on a distinguished road
Smile

Quote:
Originally Posted by jthweatt View Post
Is anyone willing to share their office policy on refunding patients? I am aware of the time limit for Medicare/ Medicaid, but want to know how quickly you refund patient overpayments. Do you have a minimum overpayment before you issue a refund? Do you require the patient pick up the check? Or do you mail it?

Thanks.
First off Roll Tide! Our office policy to do refunds a minimum of once per month. Unless of course they can be applied elsewhere.
__________________
Debbie Flieger CPC, CPPM, CPC-H, CPMA
ICD 10 CM/CT
2012 St. Louis West Chapter President
email: kdkbrebel@charter.net
Reply With Quote
Reply

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off




Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 02:32 AM.

AAPC - Top

Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
Copyright ©2014, AAPC