One of the latest trends in lost or missing money happens to be the result of electronic billing, medical insurance payments, sloppy bookkeeping practices, and perhaps even a touch of encouraging the patient to return for another visit. A growing number of patients are discovering that payments that they have made in good faith above their expected contribution are being kept more frequently by the providers who have accepted them. That is, at least until the patient comes in for another visit or has the foresight to ask for a refund.
How is this happening? Why do doctors or dentists owe their patients money? Unfortunately, a number of dental or doctor's offices are holding onto over-payments until the next visit. So many different medical or dental insurance plans exist that the co pays become a bit fuzzy as to the exact amounts. Most patients are more likely to underpay their copay than to overpay it. This is simply because they show an old insurance card with a listed co pay on it that is lower than their current copay amount.
However, there are medical and dental insurance plans that cover certain services during specific time-frames. If the dental or medical office is unaware that the patient is covered for a service or visit, the patient is charged and must pay the fee. When the insurance company covers the visit and sends a payment to the office, it is up to the patient in many cases to request a refund of the overpaid amount.
When this happens, the patient needs to submit a written request for a refund of the overpaid amount. It is important to keep a copy of this request for yourself. If the dentist is an "in network" provider for the insurance coverage that you have, send a photocopy of the request to the insurance company if the dental or medical office gives you any difficulty about returning the overpaid amount to you. If the request is not made, the office will simply hold the monetary amount in the person's account as a credit.
Plus, some plans have established annual limits that in turn change the amount of the uninsured cover. Once an individual meets his individual annual amount under his insurance plan, the amount that he owes on particular procedures will become smaller. Unfortunately, this is a fact that often goes unnoticed until the patient or the parent of the patient has made the payment, the claim is processed, and the patient receives a notice of the claim's status.
Douglas Kegler, the CEO of CollaborateMD, one of the leading medical billing companies in the US, says that in some cases, even though the patient has overpaid the account, the patient is not automatically issued a refund of the overpaid amount. Instead, the doctor's office or the dental office will retain the funds, holding them until the next time the patient comes in for some service or other. At that time, the overpaid amount is usually applied to the patient's next bill as a credit.
While this might not seem to be an issue for immediate concern, take into consideration the fact that some patients will not return to that particular office to receive their credit. Perhaps the patient will move to a new location, die in the interim, or simply switch to a new provider as the result of a change in medical or dental insurance plans. What happens to this money? In many cases, this money sits as a credit under the patient's name and account for an indeterminate number of years.
For those individuals who keep up with the statements issued by their insurance company, it is possible to notice this type of problem before it goes out of hand. Some dental or doctor's offices will remedy the situation immediately with a quick refund. However, for those individuals who would rather not wait, a simple request and a photocopy or print out of the statement will usually bring forth a refund that can be applied to other bills immediately rather than waiting six months to a year for the credit to be applied to a new bill.