I got a check in the mail the other day for $224.00.
That’s all well and good, however there’s is no explanation enclosed, other than the date of service (03/13/14) and the reason (overpayment).
In March of 2014 I had some tests done at this hospital, then I was transferred from there to another hospital for a coronary artery stent.
So, how does this happen? Why does it take 3 1/2 years to notice the error? And why does it get reported as “overpayment” (my fault) rather than “improper billing” (their fault)? I payed only what monies they demanded of me.
Most importantly, what assurance do I have that the true “overpayment” wasn’t ten times the amount they admit to?
Was health insurance involved? With numerical medical codes errors happen both on the billing side and claims payment side, someone types in the wrong digit when setting up the automatic billing or claims payment system and it might be some time before it’s noticed since it’s mostly done by computer. As a claims processor if I saw a claim that needed manual intervention for some other reason that the computer paid $750, if it did what it was programmed to do I wouldn’t know if it was really supposed to be paying $500. Once and error is finally caught then the hospital or insurance company will go back and fix them all. How far back depends but normally overpayments go back a lot farther than underpayments. It’s also possible the claim go selected for a random audit, but normally auditing doesn’t go that far back.
Yes, but I was also billed for things not covered. I looked around but have zero receipts or paperwork from the experience.
The billed for things not covered is probably your answer. If the hospital is in-network, that’s a no-no.
They probably audited accounts and sent overpayments as needed.
Enjoy your unexpected money!
Don’t look a gift horse in the mouth. I have had that happen too. Medical billing in the U.S. is notoriously complicated but not completely dishonest. Routine audits sometimes trigger refunds for things you paid for but shouldn’t have. I have $200 waiting for me because of a hospital overbilling problem. The money was turned over to the state like they were supposed to do but now I have to prove to the state why I am asking for it back 9 years later from a different address a few miles away. Apparently they aren’t aware that people move :smack:. Luckily, I have the proof but I still don’t have the money because they are a little shaky on the whole concept of people changing towns.
Spent the day it arrived.
What’s galling is the realization that for all i know they owe me more.