Wiki Insurance Question

[slewis903@yahoo.com]

Hi ,

Had a patient come in February saying she was self pay, then she finds out a month later that she did have insurance after she has already paid for the services. Now the insurance company is wanting us to submit a claim for services already paid for then once they pay us . they was us to refund her the money she paid? Are we obligated to do this? I have sent her a detail receipt on what was paid for her to send to the insurance company but they are not wanting to reimburse her? TIA

 

[mschaller]

I believe if you are participating with the insurance then your contract does obligate you to bill them.

 

[rwilliamson12]

If you are contracted with the insurance company you are obligated to submit the claims to them. If you are non-participating or out of network you do not have the obligation.