can they do this?

Question

I already paid my bill to the doctor, the amount that the insurance company said I owed. Now the doctor is sending me a copy of a letter that the insurance company sent to them, saying they got overpaid. However, the insurance company has not sent me any letter saying that I owe anything. Now the doctor wants me to take care of it. Is that legal? Shouldn't that be the doctor's problem?

Answer 1

If the doctor was overpaid, it's their responsibility to refund the payment to the appropriate parties.

My advice: call your insurance company to get clarification as to whom owes what. If they tell you that you owe nothing, ask them to conference call your doctor's office and speak to the billing manager to get it all cleared up.

Good luck!

Answer 2

You are responsible for any charges that are denied by the insurance company however you will first want to find out why it was overpaid. There are many reasons why a claim can be overpaid. Most of the overpayments I see with insurance have to deal with weather the provider was participating on your plan. It may be a discount issue and if that is the case you may not be responsible since they would write that amount off. Is it a case where they originally processed the claim as in network and now realize the provider is out of network. The only way to know for sure what you owe is to call your insurance company. Dont rely on the doctors office to tell you what you owe. Ask the insurance company what they show you owe and only pay that amount. Maybe this is an issue between the doctor and the insurance company and you are not responsible. If it was a charge that was paid in error for a service that should of been denied than you should have gotten a copy of the letter from the insurance company. There is not way to know until you call your insurance company.

Answer 3

What, the DOCTOR got overpaid? If that's the case, then the doctor should be sending YOU the overpayment amount, because YOU are responsible to the insurance company for overpayments (normally it's a deductible).

The doc bills the insurance company as a courtesy to you. They aren't actually responsible for the collections of monies from the insurance company. Legally, the doctor can only come after YOU for payment for services rendered. Your deal with the insurance company is seperate from your deal with the doc.

Answer 4

Afraid it is your problem. One of the paper forms you sign at the doctors office, states that anything not taken care of by your insurance becomes your responsiblity. You must contact your insurance right away and figure out what has happened. I would fight to have the insurance company go ahead and cover whever it is that they are now saying the do not owe. double check your policy and make sure what you are told is true. Ask for a detail list of what they paid for and get the same details of what charges were made from the doctor and compare.
Do not just sit back and let this slide, they screw you once they will continue to do so!!!!

Answer 5

Simply put, yes, your doctor's office needs to fix this. You did your part - you paid your deductible or co-payment. Then, the insurance company sent TOO MUCH money to the doctor, so now the doctor's office needs to send the over-payment back to the insurance company.

Your doctor's office sounds inept, if they really believe YOU have to fix this!

Answer 6

It depends if the doctor is in your network. If so, carriers usually prohibit this activity (called balance billing). It is the doctors problem in my opinion... Contact the carrier and let them know what is going on....

Answer 7

if the doctor's office coded it wrong to the insurance company and the ins. co. caught it......it's the doctor office's problem...not yours