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Thread: Patient Refunds

  1. #1

    Default Patient Refunds

    AAPC: Back to School
    Does anyone know where I can find information regarding regulations for the state of North Carolina and patient refunds?
    Thanks in advance!

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    can you elaborate? When are you wanting to issue refunds, under what circumstances?

    Debra A. Mitchell, MSPH, CPC-H

  3. #3


    Any time there is a credit on the patient's acct regarding an overpayment by the patient to our office. co pays, overpayment on surgical estimates, etc....is there a time frame - is there a limit on the amt? etc.
    Thank you!

  4. #4

    Default NC Patient Refund

    Anytime you have a credit balance, you are required to repay the overypayment to the correct entity/person that overpaid. You are not entitled to be unjustly enriched, which is what it would be if you kept the money.

    Each state has an Unclaimed Property law and you are required to remit all funds where you cannot find the rightful party to refund them to the state. Here is a booklet from your state that should answer any questions you have on submitting unclaimed funds.

    You cannot keep the overpayment, no matter how much time has elapsed. Having said that, under OIG guidelines, you should have an office policy established to address overpayments within 30 days.
    Cyndee Weston, CPC, CMC, CMRS
    American Medical Billing Association
    AMBACode Coding Software
    2015 AMBA National Medical Billing Conference

  5. #5

    Default patient refunds

    Good Morning everyone
    can anyone tell me if the OIG states the dollar amount that we need to refund patients for example anything less than $10.00. or is the policy patient should be refunded regardless of the dollar amount? Thanks

  6. #6
    Join Date
    Apr 2007
    Columbia, MO


    I have read I believe thru the CMS website that even if it is a penny you are required to pay it back.

    Debra A. Mitchell, MSPH, CPC-H

  7. #7


    Do you know where on the site you read that? I'd love to know! Thank you!

    April Sue

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