Practice Management Alert

Provided by Tonya Bishop, a collections specialist with Alaska Billing Services in Anchorage, Alaska, this letter works only for refund denials of non-PPO providers.

[Provider Address, PH#]

[Insurance Company Address]

Insured name:

Patient number:

Insured ID #:

Date of Service:

To Whom It May Concern:

In response to your correspondence, [Provider] is a non-participating provider with [Insurance carrier], and because of this we have decided not to reimburse any additional benefits. This account has been closed, and we are requesting that you pursue the member for any refunded amount due.

We feel that [Insurance carrier] would know its own policy payment provisions, but failed to notify [Provider]'s office as to these provisions. [Insurance company] alone made the mistake of paying beyond its responsibility. [Provider]'s billing office made no misrepresentation, had no knowledge or notice of this mistake, extended valuable service based on the assignment of payment by the insured, was not unjustly enriched, and simply had no reason to suspect that any of the payments for service rendered were in error. In the normal course of such business, [Provider] has no responsibility to determine if an insurance carrier is properly tending to its business.

If you have any questions regarding this, please contact me at the number above.

Thank you,

[Your name Your title]