Wiki Is there a dollar limit on patient refunds

[Skenyon]

We refund insurance companies regularly, however out patient credits aren't always done in a timely manner. Mostly it's for co-pays that weren't necessary, and we note the file that patient has a credit, and use it the next time they come in (we are a family practice and have many repeat customers or family members).

My real question is: If we do refund the patient because they have no upcoming appointments or have transferred out of the practice, what is the dollar limit that we must refund the patient. Someone here in my office said the policy was anything under $5.00 is not refunded. This policy was made before my time. I believe that no matter the amount, it must be refunded.

I would appreciate any thoughts from other practices.

 

[GEMTJ]

Gemtj, cpc

Most offices do what your office does: for repeat patients simply apply the credit to the next visit.
If a patient leaves the practice, the honest and legal thing to do would be to refund the balance regardless of the dollar amount (except of course it is less than a $1).
Of course since so many patients do not look at their EOBs or scrutinize the physicians bill, most of them do not even realize the have monies due to them.
Bottomline: Err on the side of honesty.

 

[btadlock1]

We refund insurance companies regularly, however out patient credits aren't always done in a timely manner. Mostly it's for co-pays that weren't necessary, and we note the file that patient has a credit, and use it the next time they come in (we are a family practice and have many repeat customers or family members).

My real question is: If we do refund the patient because they have no upcoming appointments or have transferred out of the practice, what is the dollar limit that we must refund the patient. Someone here in my office said the policy was anything under $5.00 is not refunded. This policy was made before my time. I believe that no matter the amount, it must be refunded.

I would appreciate any thoughts from other practices.

You should double check and make sure that your state doesn't have any applicable laws governing patient refunds...check out this article for more information: http://www.hcpro.com/CCP-31679-862/...cle-Tips-for-auditing-inpatient-bad-debt.html