Optometry Coding & Billing Alert

Reader Question:

Be Sure to Send Overpayments Back to Insurer

Published on Wed Oct 24, 2012

PDF

Question: I just recently went to a seminar and the instructor informed us that we should not reimburse the insurance company when an over payment has occurred. Is this a true statement? I have always refunded their money back but lately we have had an overabundance of over payments. Am I correct in sending the over payment back or do we keep the money and if the insurance company does not recoup than that is ours to keep?

Mississippi Subscriber

Answer: You are absolutely correct in refunding money that does not belong to you. In fact, you are required to refund the money in a timely manner. There's no good reason why anyone would inform you to not return money that does not belong to you.

The OIG can serve a practice with a Corporate Integrity Agreement (CIA) specifically for not refunding payers and patients for overpayments. This is an area of fertile ground for whistleblowers to report to the government. Always refund overpayments!

Optometry Coding & Billing Alert

Evaluations:
Determine the Difference Between Intermediate and Comprehensive Exams
Other options include E/M and S-codes, but choose wisely.CPT® divides general ophthalmological services into new [...]

Billing Corner:
No-Shows? No Problems With These 4 Expert Tips
No-show fees are one approach, but beware the PR backlash.These days every dollar and every [...]

News You Can Use:
Get Used to Revalidation Process, Medicare Warns
Plus: CMS will begin accepting faxed, emailed supporting documents.If CMS's revalidation process has been a [...]

Correction:
The article "92134 Basics: Avoid These Pitfalls and Keep OCT Coding on Track," in Optometry [...]

You Be the Expert:
Visual Fields for Glaucoma Suspect
Question: We keep getting denials for 92082 and 92083 (Visual field examination ...) linked to [...]

Reader Question:
92226 Requires Proof EO Is Actually Extended
Question: I just got a denial on 92226. I think I might be using this [...]

Reader Question:
Be Sure to Send Overpayments Back to Insurer
Question: I just recently went to a seminar and the instructor informed us that we [...]

View All