Wiki COB issues

[Gator]

When you have a credit due to both insurance policies paying as prime and neither insurance will take their money back because they both think they are prime what do you do with the credit? You have reached out to the patient a number of times asking them to update COB w/both insurance companies. The patient insists they have but, still both insurance are paying as prime. Federal Blue is prime as the patient is the policy holder. Regular Blue cross should be secondary because coverage is held by the spouse. Both insurances after multiple inquiries insist they have paid correctly as prime and will not take their money back.

 

[csperoni]

I would leave the credit on the system. Most likely the secondary will eventually get their act together and then request the refund. As long as I have done my due diligence, and notified the carriers, I can't force them to take back the incorrect payment.

 

[catherinetinkey@entmedicalservices.org]

We call the insurance to verify the patient has called them, if they can't see that the patient has called, we call the patient and let them know that there is no record of them calling and they will need to call again and get a name and call reference # for their COB conversation. We have the patient call us back when this is done. Then we will actually call a couple more times to the insurance company. If they don't recoup we leave the credit on the patients account for up to two years, if the insurance company doesn't recoup $ within 2 years we apply to patient's future balance. If they are not coming back in I would refund the patient after 2 years, it was their policy.