If you overpay your bill and doctor does not refund, what to do?

[Anonymous]

I overpaid what I owed the doctor for medical services based on what I'm obligated to pay based on contracted fees with the insurance company. I've called and left a message on voicemail and with her assistants 3 times over a couple months. Doctor is not returning my calls to clarify whether I have or have not overpaid.

I spoke with the insurance company and they said I have to resolve it with the doctor. The amount I overpaid is a couple hundred dollars. What is my recourse? Any ideas?

[Anonymous]

Keep good records and make a written request by certified mail. If that doesn't work go to the office and demand a refund and explain that you will file a complaint (not sure with who tho). Or count it as a credit and use it on your next visit?

[Anonymous]

If you are in MD, file a complaint with the Attorney General's office. They have a special division for issues with medical billing etc. The forms are on-line and it is really easy. Good luck.

[Anonymous]

This is OP. I'm in VA. It's really too bad bc I liked the doctor, maybe I like more her office bc it's contemporary and looks clean. Maybe she's having money problems like everybody else, but hey, when I have money problems, they still want me to pay for their services, even if it's only a $20 co-pay. Overall, I don't want to sour the relationship too badly, with the karma thing and all.

Most doctors' offices (like 100%) I've been to bill me for the balance that I owe, but at the end of the visit, this one wants me to pay for an estimate of what they expect my insurance will not cover. Hence, I overpaid and the doc's not responsive.

Anybody have experience with something like this of overpaying and having the doctor not respond? What did you do?

[Anonymous]

I had a similar experience with the GWU travel clinic (for travel shots). They told me insurance didn't cover them, but it ended up mine did. In the meantime I'd paid full price. Insurance reimbursed me for some, and GWU was obligated to refund the difference. It took several months and many phone calls and faxes, but they finally reimbursed me. I think you just need to be persistent. I would also recommend speaking with someone (even your doc) in person, and/or identifying one person to be "responsible" -- get their name when you call and check back in with them until they handle it.

[Anonymous]

PP here - I also think it's strange that you are expected to pay more than the copay. There should be an "allowed" amount (like in your past experiences with other offices) that they can bill you once the insurance payment goes through, but it seems very strange that they try to estimate that up front -- what are they doing, estimating how much they're overbilling you?? Weird. I would definitely address the whole issue in person next time you're in the office (or just drop in, if you have time).

[Anonymous]

Anonymous wrote:PP here - I also think it's strange that you are expected to pay more than the copay. There should be an "allowed" amount (like in your past experiences with other offices) that they can bill you once the insurance payment goes through, but it seems very strange that they try to estimate that up front -- what are they doing, estimating how much they're overbilling you?? Weird. I would definitely address the whole issue in person next time you're in the office (or just drop in, if you have time).

I've seen this before. In one case, the office had questionable billing practices and may have been fraudulently billing the insurance company. There were always patients complaining about their bills but I think the ones who had excellent insurance or did not pay close attention let it go rather than challenge them.

[Anonymous]

OP, this can happen if you are out of network or agree to accept what insurance pays YOU. I think that this is not your case since you say that you've been with this doctor for some time.
But if the doctors fees are X, and you paid X, then they weren't overpaid unless that doctor participated with a plan. If the insurer pays you, X-Y, then that difference could be your responsibility.

[Anonymous]

Anonymous wrote:This is OP. I'm in VA. It's really too bad bc I liked the doctor, maybe I like more her office bc it's contemporary and looks clean. Maybe she's having money problems like everybody else, but hey, when I have money problems, they still want me to pay for their services, even if it's only a $20 co-pay. Overall, I don't want to sour the relationship too badly, with the karma thing and all.

Most doctors' offices (like 100%) I've been to bill me for the balance that I owe, but at the end of the visit, this one wants me to pay for an estimate of what they expect my insurance will not cover. Hence, I overpaid and the doc's not responsive.

Anybody have experience with something like this of overpaying and having the doctor not respond? What did you do?

Sometime if you haven't met a deductible yet or depending on your insurance coverage, medical offices may take a "deposit" of what they estimate as the fee. If you overpaid, contact the office manager. If the messages aren't going through then send a letter or stop by in person. I don't think most certified physicians are trying to steal your money. Their reputaion would more valuable. If they use an out side billing company, ask for their contact information and speak with a billing representative. Be sure to have your receipt.

[Anonymous]

If she owes you money and won't take your calls, how can you like her.

I would send a registered letter.

If that failed, small claims court. First get a copy of your records, though.

[Anonymous]

Maybe it is only the administrative staff who is ignoring OP. Contact the doctor directly if you can.

[Anonymous]

I agree that you should send a registered letter describing the situation and the attempts you've made to resolve it, and include a deadline in the letter for a response to you. If they haven't responded by the deadline, send another registered letter informing them that if they don't respond by X date, you will pursue legal action.