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Overpayments

  1. Question Overpayments
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    I hope someone can help...I have been getting overpayments from insurance companies and they don't want to take them back they either say its ours to keep or the patient gets it. I have never heard of this. I was always taught you can never get more than the charged amount and it always goes to the person who gave it to you. can they do this by law?

  2. #2
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    Lauderdale Lakes
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    Why are you getting overpayments? Is it that the patient has more than one insurance?

  3. #3
    Location
    Tacoma, WA
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    Quote Originally Posted by laurabryant View Post
    I hope someone can help...I have been getting overpayments from insurance companies and they don't want to take them back they either say its ours to keep or the patient gets it. I have never heard of this. I was always taught you can never get more than the charged amount and it always goes to the person who gave it to you. can they do this by law?
    Are these secondary insurance payers? Sometimes there are situations where in the course of coordination of benefits a secondary payer pays more than what remained after the primary paid. Some secondary's will not accept the overage back. Do not send it to the patient as the money is not theirs either. As long as you have made an attempt to return the overage, we usually write these balances off to an in-house tracking account in case at some point in the future the insurance wakes up and wants their money back! Your state might also have an unclaimed properties department you could forward the money to.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  4. #4
    Location
    Columbia, MO
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    12,570
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    Actually in most cases the patient does get the excess paid out to them. You need to check the laws on this. If the patient has paid premiums to 2 payers and both payers paid to a degree that results in an overpayment then the excess is the patients. In most cases. You should really dig deeper on this but the provider may not keep the excess.

    Debra A. Mitchell, MSPH, CPC-H

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