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Medical Forum / General / Dentistry / March 2007overpayment collection
I had a dental work (implants) done last year, my former health insurance paid a portion of it and I paid the rest. Afterwards the insurance company send me a check for $2000+ as a benefit under my secondary coverage. Now they are trying to collect this amount back claiming that it was a mistake. I don't have a primary coverage anymore from this insurer (Blue Cross) and I live in a different state now. They keep sending me notifications and threatening to involve a collection company. Anyone has an advise what to do in my situation? Thanks. >I had a dental work (implants) done last year, my former health >insurance paid a portion of it and I paid the rest. Afterwards the [quoted text clipped - 5 lines] >collection company. Anyone has an advise what to do in my situation? >Thanks. Send the money back. > I had a dental work (implants) done last year, my former health > insurance paid a portion of it and I paid the rest. Afterwards the [quoted text clipped - 5 lines] > collection company. Anyone has an advise what to do in my situation? > Thanks. Well, were you eligible for secondary insurance benefits as of the date of service? If you believe you were eligible, you might wish to contact the state insurance department where the treatment was rendered. If they can't help, it's a legal matter. You should consider how involved you wish to get with the insurance company, considering the legal fees may be high. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >> I had a dental work (implants) done last year, my former health >> insurance paid a portion of it and I paid the rest. Afterwards the [quoted text clipped - 14 lines] > >Steve Do ya think the money's already spent ? <rhetorical> >>> I had a dental work (implants) done last year, my former health >>> insurance paid a portion of it and I paid the rest. Afterwards the [quoted text clipped - 16 lines] > > Do ya think the money's already spent ? <rhetorical> You know, I've gotten insurance overpayments from time to time. I've promptly returned them, then sometimes months later get dunned to return a check I already have. I have to keep records of the return to keep me out of trouble. No good deed goes unpunished. Steve From a business point of view (without contracts to the respective companies), honestly submitted claims that the insco overpays *DO NOT* need to be refunded. You are not responsible for an insco's mistakes for overpayment. In fact the response to give the insco is to get the overpayment from the patient. They are the person who received the benefit. Steve > You know, I've gotten insurance overpayments from time to time. > I've promptly returned them, then sometimes months later get dunned to > return a check I already have. I have to keep records of the return to > keep me out of trouble. No good deed goes unpunished. > > Steve > From a business point of view (without contracts to the respective > companies), honestly submitted claims that the insco overpays *DO NOT* [quoted text clipped - 6 lines] > > Steve Just to be clear--it had been a payment made to me. That was bad enough--had they paid the patient I can't imagine they could try to enlist me as their collection agent. Steve >> You know, I've gotten insurance overpayments from time to time. >> I've promptly returned them, then sometimes months later get dunned to >> return a check I already have. I have to keep records of the return >> to keep me out of trouble. No good deed goes unpunished. >> >> Steve OK, I do a molar endo and crown on #14. Total fee is $1,800. The estimated insurance benefit is $1,000. The treatment is finished and the insco sends me a check for $1,250. The patient's account balance is adjusted appropriately and gets $250 either as a refund for overpayment or credit against other charges. Six months later the insco sends me a note saying they made a mistake and want *ME* to refund the $250 to them and collect the balance from the patient if I so chose. Oh no they don't! They made the mistake. If they want that $250 back, they can go to the patient and get it from them! I did not benefit from their mistake. The patient did. I will not try to collect for them. Inscos have tried this game with me on more than one occasion, and I simply refuse to play. Don't get me started, or I'll call Wubba<G>. Steve >> From a business point of view (without contracts to the respective >> companies), honestly submitted claims that the insco overpays *DO NOT* [quoted text clipped - 12 lines] > > Steve I do the same as SF. Signature/ Amatus / > > OK, I do a molar endo and crown on #14. Total fee is $1,800. [quoted text clipped - 35 lines] >> >> Steve > OK, I do a molar endo and crown on #14. Total fee is $1,800. > The estimated insurance benefit is $1,000. The treatment is [quoted text clipped - 15 lines] > > Don't get me started, or I'll call Wubba<G>. I don't think I've had that precise scenario. I agree with you, but I'm not going to research the state insurance law to figure out the legalities--until I have to. Steve > Steve > [quoted text clipped - 14 lines] >> >> Steve >OK, I do a molar endo and crown on #14. Total fee is $1,800. >The estimated insurance benefit is $1,000. The treatment is [quoted text clipped - 17 lines] > >Steve And you know that I will be there promptly with a super sized can of WA... >>> From a business point of view (without contracts to the respective >>> companies), honestly submitted claims that the insco overpays *DO NOT* [quoted text clipped - 12 lines] >> >> Steve And you know that I will be there promptly with a super sized > can of WA... That's what I'm talkin' 'bout. Steve > And you know that I will be there promptly with a super sized >> can of WA... > >That's what I'm talkin' 'bout. > >Steve It's what us dudes from R.I. are all about ! |
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