Wiki What to do with overpayment

[amym]

We have a patient that has Medicare, Aetna and AARP. Medicare processed the claim as primary and crossed over our claim to AARP. We had Aetna in our system as the secondary and submitted the claim to Aetna. Both Aetna and AARP paid as secondary and neither of them will take their money back stating they paid according to the patient's benefits. What do I do with an overpayment? I heard in the past that it should be mailed to the patient but what if one of the insurance companies decides that they overpaid and requests their money back? Please help!

 

[ams55]

overpayment

The same thing happened to me. I called both second insurances again to find out who was the correct second insurance at the time of the date of service. I returned the payment to the carrier that was not in effect at the time of the date of service. It took more than one phone call but it was resolved properly and correctly. Good luck.

 

[annawade13]

I have run into this same problem, especially with patients who have Medicare, Tricare, and a commercial supplement like AARP. I have questioned again and again, and the carriers have always insisted that in cases were all three insurances are active and all payments are legitimate, the overage is given to the patient. I just always triple check coverage before refunding the patient. Hope this helps!

 

[EricaR]

This does happen all the time, we always call to be sure it is a true patient credit but then it does go to the patient. I believe this is happening when a patient has a pure Medicare supplement along with another policy. The AARP Medicare Supplement does not coordinate benefits with anyone but Medicare so they will pay what they pay after Medicare regardless.