Insurance Company Refund - Wrong Amount. What would you do? A month ago I went to the doctor office..?

Question

The bill was $500, I have a high deductable Insurance Plan so I do have to pay for all my bills,The thing is that some of the lab test that the Doctor ordered for me were not performed 'cause someone lost my samples. Anyway, for 2 weeks straigth I tried to reach the lady that does the billing and that stuff, they ignored me, I had to explain the situation over an over to different people and nothing happened. Last week finally I got to talk to the Manager and explain that all I wanted is a refund for the procedures that were billed to me but not performed, she said she will take care of it. Yesterday I got a long letter with an explanation and to make the story short They are giving me a refund for the same $500.00 that I paid, this is wrong, totally wrong, 'cause they did perform the other services and there is only 2 things they should be giving me a refund for. They are clueless, Should I take the money and wait for them to come after me or try to make them understand is a mistake?

Answer 1

They will bill your insurance for what they did. Your insurance will consider the charges at the contracted rate and apply it to your deductible. Your doctor and you will both get the same explanation of benefits. The doctor will send you a bill for the contracted amount, you will send payment. You should not pay the full amount, but the contracted amount that your insurance has with the doctor.

Contact your insurance to make sure they have (at least) recieved the bill and ask how long it usually takes to process the charges. That way, you will know (approximately) when you will be receiving the bill from the doctor's office.

Answer 2

The refund is probably like starting over... Most likely they have to file a corrected claim to your insurance & wait to see how much $ is applied to your deductible. Wait a couple of weeks. & then bring it up again with the doctor's office.

Answer 3

Do you have an itemized bill showing the cost of the two tests they did not run?  If it were me I would just cash the check and walk in a check for the difference (i.e. the amount you should owe) and be done with the whole thing.  It could be a year before they notice and who knows what financial situation you will be in then.  i realize they made the mistake, but you would be better off not having to deal with this situation again.  When you walk in it would be best to have the itemized bill and show them, then hand them the check for the difference.

Good luck to you!

EDIT-

I run into folks every day that "just don't get" what your trying to tell them so I feel your pain here.  Perhaps they do won't understand until you sit with them and show them exactly what you are talking about.  Or perhaps they are refunding all your money as some kind of good faith effort since they feel bad for causing you all this trouble.  Unlikely, I know, but I have seen stranger things happen!

Hope it all works out for you and you don't have to worry about this much longer!