Wiki IS THIS CONSIDERED DOUBLE DIPPING?

[Pkirsch1]

When an insurance pays the claim, and later finds out that insurance expired before they paid the claim. Before they take the money back the patient calls in her new insurance that started the same date of the claim (or before). Can we bill the new insurance while still having the monies from the old?

 

[csperoni]

You should be refunding the money to the insurance company that incorrectly paid. If there's a few days of overlap from when you billed the new to when the refund check was actually sent, I don't see that as an issue. In general, you should be sending a refund as soon as practical when an overpayment is discovered. There may be some insurance contract stipulations or state requirements for the maximum amount of time, but it should be within days.

 

[Pkirsch1]

You should be refunding the money to the insurance company that incorrectly paid. If there's a few days of overlap from when you billed the new to when the refund check was actually sent, I don't see that as an issue. In general, you should be sending a refund as soon as practical when an overpayment is discovered. There may be some insurance contract stipulations or state requirements for the maximum amount of time, but it should be within days.

Thanks for your help!

 

[Bluteam]

Medicare Advantage Plans the rule for our credit team is under 5.00 they will not refund the payer. To me it is wrong but when asked about it I was told that that is the dept. that sends the refunds out. Facility biller for many years and I have sent back 1.00 to payer which is correct?