Reader Questions:
Resolve Secondary Payer Issues With Conversations
Published on Mon Sep 06, 2010
Question: Our doctor performed surgery on a patient 11 months ago. We just learned that the patient had primary and secondary insurance at the time. The payer she said was secondary was really primary. The secondary insurance company paid us as primary, however. Are we obligated to refund the money even though it's been almost a year?Connecticut SubscriberAnswer: Since you found out about the error -- for example, if the patient called your office several months later and explained the situation -- you should call the payer and notify them know of the error. Then, leave it up to the payer as to how to proceed as long as they make a decision quickly -- don't let the issue drag out past timely filing limits. The payer may not do anything because so much time has passed, or it may work directly with the patient to solve the problem.Good news: If a patient makes a [...]