This patient was originally seen on 4/25/16, at that time we collected a $30 copayment. Within a week, we were contacted by their private insurance company informing us that their coverage was terminated but they would cover the patient for 31 days from 4/2/16. Patient came back again on 5/06/16 for...
a sick visit. At that point and time Mr. & Mrs [redacted] were aware that they did not have any insurance coverage and were expected to pay for the visit which totaled $318.27. Mr [redacted] even made a payment arrangement because he was unable to pay for the visit in full. He came again on 5/12/16 to pay the remaining balance. On 5/17/16 Mrs [redacted] contacted our insurance department stating that she now had government insurance with an effective date of 5/1/16 and added date of 5/11/16. She stated she was unaware that they would be getting this insurance so she never advised our insurance department on the day of the visit that she could possibility be receiving this insurance. Our office policy states that if the government insurance is not active at the time of the service/date of visit, patient's are held responsible for the claim and we will not resubmit the claim to the new insurance even if the insurance allows retroactive payment. In order to stay in compliance, we must maintain these policies across the board to all patients who deal with this government insurance. We reminded Mrs [redacted] at the time of the call on 5/17/16, but she was insistent about wanting her money back. We sent her office copies of all our talks and any documentation to help her understand our policy. We do appreciate their business for the last 10 years but we must treat all our patients the same way and we must uphold and adhere to our established office policies.
This patient was originally seen on 4/25/16, at that time we collected a $30 copayment. Within a week, we were contacted by their private insurance company informing us that their coverage was terminated but they would cover the patient for 31 days from 4/2/16. Patient came back again on 5/06/16 for...
a sick visit. At that point and time Mr. & Mrs [redacted] were aware that they did not have any insurance coverage and were expected to pay for the visit which totaled $318.27. Mr [redacted] even made a payment arrangement because he was unable to pay for the visit in full. He came again on 5/12/16 to pay the remaining balance. On 5/17/16 Mrs [redacted] contacted our insurance department stating that she now had government insurance with an effective date of 5/1/16 and added date of 5/11/16. She stated she was unaware that they would be getting this insurance so she never advised our insurance department on the day of the visit that she could possibility be receiving this insurance. Our office policy states that if the government insurance is not active at the time of the service/date of visit, patient's are held responsible for the claim and we will not resubmit the claim to the new insurance even if the insurance allows retroactive payment. In order to stay in compliance, we must maintain these policies across the board to all patients who deal with this government insurance. We reminded Mrs [redacted] at the time of the call on 5/17/16, but she was insistent about wanting her money back. We sent her office copies of all our talks and any documentation to help her understand our policy. We do appreciate their business for the last 10 years but we must treat all our patients the same way and we must uphold and adhere to our established office policies.