Can doctor’s office receive payment from a patient and their insurance company for a single visit? Is this double billing and insurance fraud?
Get Legal Help Today
Compare Quotes From Top Companies and Save
Secured with SHA-256 Encryption
Can doctor’s office receive payment from a patient and their insurance company for a single visit? Is this double billing and insurance fraud?
I have a health care reimbursement account through my insurance company. I went to the doctor on May 20th. They said they do not accept health care reimbursement accounts and I had to pay for the visit. They billed my insurance company and the insurance company paid 100% of the bill with funds in my health care reimbursement account. The doctor’s office has been paid twice for services render on May 20th. The doctor’s office received payment from the insurance company over a week ago. They have not refunded my portion. What are my options?
Asked on June 22, 2009 under Insurance Law, Oklahoma
Answers:
B. B., Member, New Jersey Bar / FreeAdvice Contributing Attorney
Answered 14 years ago | Contributor
You should get whatever you paid in person on May 20th refunded, absolutely. I'm not surprised that you haven't gotten the money back, because a week isn't a terribly long time in a situation like this. I'd start with a polite telephone call, asking when you can expect to see the money. The next step would be a letter (ideally certified, return receipt requested), again polite, with a copy of your receipt from May 20th and a copy of the statement you got from the insurance company showing that payment.
If that doesn't work, talk to a lawyer in your area. There are differences in the law and procedure from one state to another, and I don't practice in Oklahoma; also, all the facts of your case can be important, and your attorney will need that information to give you reliable advice. One place to look for a qualified attorney is our website, http://attorneypages.com
IMPORTANT NOTICE: The Answer(s) provided above are for general information only. The attorney providing the answer was not serving as the attorney for the person submitting the question or in any attorney-client relationship with such person. Laws may vary from state to state, and sometimes change. Tiny variations in the facts, or a fact not set forth in a question, often can change a legal outcome or an attorney's conclusion. Although AttorneyPages.com has verified the attorney was admitted to practice law in at least one jurisdiction, he or she may not be authorized to practice law in the jurisdiction referred to in the question, nor is he or she necessarily experienced in the area of the law involved. Unlike the information in the Answer(s) above, upon which you should NOT rely, for personal advice you can rely upon we suggest you retain an attorney to represent you.