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Wiki surplus on insurance payment

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codecrazy

Networker
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97
Location
Cocoa, FL
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This patient has a commercial insurance that pays more than half of the billed amount. The patient takes the eob and sends it to champva who pay more than what the balance of the bill is. The check is made out to the patient.
Champva did recieve the eob. So why did they over pay? The check is written to the patient,:confused: do I give him the balance? They some times pay the correct amount and other times do not. How should I procede?
 
My office has the same problem but our checks are not made out to the patient. Usually the overpayment is credited to the patient's account and then sent back to Champus, at some point they will realize the error and ask for a refund. I would call Champus because the patient should not be making a profit from the claim. Hope this helps,
Cindy
 
This is pretty common actually. The actual balance due should be billed to the patient and the patient keeps any surplus. Then if the insurer asks for a refund, it comes from the patient. Most often, the patient does make a profit in these types of scenarios......very strange.;)
 
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