Daria Posted December 18, 2015 Share Posted December 18, 2015 My insurance company loves to mess up the billing, and to find ways to slow the process down. Usually they underpay and I have to fight, but for the second time now they have overpaid me. The last time this happened, I called them as soon as I saw the incorrect Explanation of Benefits. They then froze my check, and demanded that I "prove" that I had only paid the doctor $200 instead of $300. They basically accused me of lying about how much I'd paid in order to defraud the insurance company into $60. As if that's a real problem insurance companies have, people calling them up and lying so they can get less money back. It was a mess and took me months to get my money. So, this time, I'm wondering what will happen if I wait for the check, deposit it, and then contact them. I can put aside the portion that's overpaid so I'm ready to mail it back. Or they can take it out of the next claim. Does that make sense? Is there a legal or ethical idea why that's a bad idea? The portion that they overpaid is only about 10% of what they owe me, and I'd really like to get the 90% that truly is mine sooner rather than later. Quote Link to comment Share on other sites More sharing options...
Lawana Posted December 18, 2015 Share Posted December 18, 2015 Yes. I would deposit the money and then settle up. That is not unethical. 3 Quote Link to comment Share on other sites More sharing options...
Daria Posted December 18, 2015 Author Share Posted December 18, 2015 Yes. I would deposit the money and then settle up. That is not unethical. How hard would you work to settle up? Last time when they kept asking me for documentation to prove that they had misread the receipt, I really wanted to say "no", but because they were keeping the rest of the money on the claim, I couldn't. In this case, I'd like to just tell them what happened (they misread) but not go any further if they won't believe me. Is that reasonable? Quote Link to comment Share on other sites More sharing options...
Spryte Posted December 18, 2015 Share Posted December 18, 2015 How hard would you work to settle up? Last time when they kept asking me for documentation to prove that they had misread the receipt, I really wanted to say "no", but because they were keeping the rest of the money on the claim, I couldn't. In this case, I'd like to just tell them what happened (they misread) but not go any further if they won't believe me. Is that reasonable? What a mess. I'd deposit the check, then notify them by phone. I'd probably go so far as to send a copy of the paid receipt by mail, but that's all I'd do. Does this always happen with the same doc's office? 1 Quote Link to comment Share on other sites More sharing options...
Serenade Posted December 18, 2015 Share Posted December 18, 2015 (edited) Honestly, unless it was a really huge amount, I probably wouldn't say anything, but I wouldn't spend the extra money, either, because they'll figure it out in time and want it back. Then you can calmly write a check and send it back. Your time is worth something, too, and it seems like you spent a lot of your time trying to work out the last hassle. I remember once trying to convince a grocery store manager that the store didn't charge me enough, and that manager could just not figure it out. That is the last time I tried to give money back. Now I figure most things work out over time, at least for relatively small amounts. Sometimes I'm overcharged, sometimes under, but I think I come close to breaking even over time, and I'm not spending my time and bother on it. ETA: It's time and effort for the business to settle these things, too. I think often, again, if the amount is relatively small, that the business would rather not deal with it, either. I think that's what happened to me with the grocery store manager. Edited December 18, 2015 by Serenade Quote Link to comment Share on other sites More sharing options...
Lolly Posted December 18, 2015 Share Posted December 18, 2015 How hard would you work to settle up? Last time when they kept asking me for documentation to prove that they had misread the receipt, I really wanted to say "no", but because they were keeping the rest of the money on the claim, I couldn't. In this case, I'd like to just tell them what happened (they misread) but not go any further if they won't believe me. Is that reasonable? I would deposit the check. I would make sure to have the amount they missed by available. I would not notify them of the mistake (unless it was large which it sounds like this isn't). If they contact me, I would immediately write them a check for the amount and mail it to them. If they later make a mistake in their favor for a similar amount, I would not bother to point it out to them. Overall, I wouldn't think about this too much and must move on. (There is a good chance that rectifying this mistake will cost them more money than you just keeping it.) 1 Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You can post now and register later. If you have an account, sign in now to post with your account.