Ophthalmology and Optometry Coding Alert

Question: I just recently went to a seminar and the instructor informed us that we should not reimburse the insurance company when an over payment has occurred. Is this a true statement? I have always refunded their money back but lately we have had an overabundance of over payments. Am I correct in sending the over payment back or do we keep the money and if the insurance company does not recoup than that is ours to keep?

Mississippi Subscriber

Answer: You are absolutely correct in refunding money that does not belong to you. In fact, you are required to refund the money in a timely manner. There's no good reason why anyone would inform you to not return money that does not belong to you.

The OIG can serve a practice with a Corporate Integrity Agreement (CIA) specifically for not refunding payers and patients for overpayments. This is an area of fertile ground for whistleblowers to report to the government. Always refund overpayments!