Wiki Refund requests for COB

[THK]

Can anyone tell me how they handle the refund requests from insurances a year to two years after the service was covered, requesting their money back due to COB issues, but the primary insurance's timely is past so even if we bill it will deny for timely?
I am getting more and more and even with timely appeals to the prim insurance we are not getting paid.

 

[dstruve]

Save your request for refund letter and send it in with an appeal after you get your timely filing denial. It's more work and a lengthy process but we get paid on most of them this way.

 

[catherinetinkey@entmedicalservices.org]

First, was it your fault or the patients that the insurance was submitted to wrong primary insurance? If the patient did not give you the information I would have the patient sign a waiver that states insurance information was not given to you in a timely manner and patient maybe financially responsible due to timely filing. When sending in the claim I would attach a GA modifier (shows you have a signed waiver), if claim denies for timely I would then do a reconsideration attaching the waiver and the recoupment letter from the original insurance. If you don't want to do any of the above, I would send in the recoupment and bill the patient, let them handle the situation with the insurance companies.