Did you know that when an insurance company makes a mistake involving an overpayment to a healthcare provider, the healthcare providers are required by law to report that overpayment?
I discovered an error and reported it. The insurance company reprocessed the claims they had denied; however, the secondary insurance company had already stepped up to the plate and acted as the primary insurance company and paid the claim. Meanwhile, the healthcare provider had been paid by both insurance companies and were still sending me an invoice for the difference between the amount charged and the allowable fee.
When I tried to inform the insurance company that the healthcare provider had collected double (sometimes more) the amount owed, I was informed that it was the healthcare provider’s responsibility – they are required by law – to report the overpayment. the insurance company was NOT interested in the information I had to offer. Amazing!!