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Thread: ASC Sues patient for refusing to turn over insurance check

  1. #1

    Default ASC Sues patient for refusing to turn over insurance check

    AAPC: Back to School
    I thought this would be interesting for those of you who are dealing with payers who send payments for non-contracted providers (BCBS!!!!) to the patients.

    A Newark, N.J., man has been accused of refusing to forward an insurance payment to Northwood Surgery Center in Lower Nazareth Township.

    Colonial Regional police say Derrick Garland, 45, received a $13,062 check from Highmark Blue Shield following treatment at the center for his wife, Sonya Garland. The entire medical bill was $31,080.

    Police say the staff at Northwood Surgery Center in the 3700 block of Easton-Nazareth Highway repeatedly contacted Garland, asking that he forward the money, but he did not.

    He was arraigned Thursday on a charge of failure to make required disposition of funds. He was released on $10,000 unsecured bail.


  2. #2
    Join Date
    Apr 2007
    Marietta, GA


    That very situation happens to us too in our ASC, and it is because BCBS won't send the payment to to the facility. It's unfortunate, but we do sue patients that keep the money too. We have explained to them how the process is going to work, and they sign papers stating they will turn the checks over to us. It's a shame it has to come to this, but what other choice do the facility owners have. Very interesting, I'm sure this is happening all over the country. If you ask me, this could all be avoided if BCBS would send the payment to the facility. Luckily this doesn't happen very often though. Most people are honest and do the right thing.

  3. #3
    Join Date
    Apr 2007
    Charleston, South Carolina


    The patient can also be referred to the IRS and state tax board for "unreported" income. The IRS WILL take care of it!!
    Machelle Morningstar, CPC, COC, CEMC, COSC
    AHIMA Approved ICD-10-CM/PCS Trainer

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