December, 2015

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Dealing with Overpayments When Billing Medical Claims


Sometimes the hand is repaid too much money for services rendered resulting in overpayment. Sometimes the overpayment is made by the insurance carrier and sometimes it is done by the patient. In both cases, it is important that the overpayment returned to the appropriate person or vehicle.

If the patient pays more than they need the patient must be notified as soon as the overpayment is discovered. Overcompensation can be applied to a future visit if the patient will return but only if the patient agrees. The provider not just constantly keep the money.

An example would be if a patient came in for an office visit and pay co-pay. The provider ends up removing the mole is considered an action and does not require a co-pay resulting in overpayment. When the office realizes co-pay should not have been collected they can do one of two things.

1. Report patient overpayment. If the patient back to the office can suggest that they take it as a credit toward the next visit. If the patient does not want to apply it to a future visit, the overpayment will be returned.

2. Send the patient check for the overpaid amount with a note explaining the overpayment.

In any case, there can not just keep overpayment. It is illegal.

If an insurance carrier for the payment it is important to first determine whether it is truly the payment. Call the artist who made the overpayment and ask them to explain how they determined the amount of their claim if they work properly. If they confirm that they did make an overpayment they should recycle claim to show the correct payment and send the request to the provider to return the overpayment.

Sometimes they just want to ask for your hand over the phone to return the overpayment. Personally, I always ask them to ask for the money back with a written explanation. When you receive a written request for overpayment attach a check for the overpayment to the request and send it to the address stated in the request. If they do not address send it to the requirements of the deal indicate. “Note: Overpayments”

if you receive payment from the insurance carrier and the entire payment is wrong or incorrect due to hand write “void” on the check and return it to the insurance carrier with an explanation of why the payment was not due . For example, if the payment is for a patient that was not seen by hand, write “void” on the check and attach a note saying “This patient was not seen in our office.”

If the state of the call they work claims and that there was no overcompensation then you need to decide if it truly was an overpayment. Sometimes the patient two insurance plans. Main makes a certain amount and then makes the payment of the secondary process claim and allowing a higher amount than the primary insurance carrier resulting deposit.

This is not really an overpayment. The amount of the contract adjusted away from the primary insurance carrier was more than needed to adjust based off payment of secondary insurance carrier. Therefore, it is not true overpayment and no money needs to deliver. Balancing the patient just needs to change in order to offset the credit.

Sometimes another insurance carrier patient privately purchased insurance. They do not always follow the same guidelines as other insurance carriers. Many times they ignore the main paid and make the payment and if no other insurance is involved resulting in overpayment. In this case, the overpayment amount belongs to the patient where they bought the insurance plan. The provider does not just keep the money. The provider does not collect more than he or she charged out for their services.

It is important to overpay are not ignored. First, decide whether it is true overpayment. If it is, decide who overpayment must be returned to them and do what is necessary to deliver it. Remember just lend it to future visit with the permission of the patient

Copyright 2010 – Michele Redmond – Medical Billing Solutions Inc


Health Care


Hello all you wonderful people out there. If there is one subject that affects each of us is our health. What is the best way to care for our health?

Let’s take a brief look at some of our options for the care of our health.

Some believe in preventive measures to see to their health. What exactly does this mean? Basically, it means eating a balanced diet, exercise properly and live a healthy life. A yearly check-up is also a good way to know what shape you are in and cover all developing disease.

An unpleasant aspect of modern life is stress. It is a fact of life. Fortunately, there are many ways to deal with stress. Traditional medicine is one approach – relaxation therapy. Meditation is another method. In between are such options daily rest (even for ten to twenty minutes), spend part of every day in a relaxing environment, take a break, a change of scenery, a holiday. A good laugh, whether funny jokes or funny situations is highly recommended to keep mind and body in good shape.

None of us is infallible. We are prone to illness. What are our options when we become ill? Again traditional medicine. Medicines for almost every disease under the sun is available.

Personally, when something out of the norm is detected on the test my blood, I make a bee line to the office dietician is. By eating the food, the vitamins required by the body, balance can be regained.

There is more than one way to do things. You decide what makes you feel good and you want to be healthy. After all, health is wealth.


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