Magazine article Medical Economics

Q & A: Practice Management

Magazine article Medical Economics

Q & A: Practice Management

Article excerpt

Refunding a reimbursement

Your experts said that when an insurance carrier asks you to refund reimbursement sent in error, you should do so and then bill the patient. But what if the patient came to you out-of-network and assigned his benefits to you? Shouldn't returning the payment be his responsibility?

That's correct. In that case, it's the patient who has the agreement with the carrier, not you. Send the plan a letter directing them to seek the refund from their insured. Send copies of your letter and the carriers refund request to the patient.

When a deadbeat wants an appointment

Recently a patient with a large overdue balance called to schedule an appointment. He's been ignoring the collection agency for a year, and it's hard to believe he has any intention of ever paying me. How do I handle him?

You probably have to see him. If you haven't formally dismissed him from your practice, he's still your patient. Withholding treatment may constitute abandonment.

So first find out why he wants an appointment. Of course, if it's an emergency, tell him to come in at once-or go to the ER if you can't manage his problem in your office.

If it's a nonemergency condition you've treated him for previously, tell him you'll work him in. But say that he'll have to pay for the service up front. If he demurs, bite the bullet, and see him anyway. It's not worth an abandonment charge. (Also, never turn away a sick child-it's too dangerous, medically and legally. …

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