Princeton Healthcare System

Patient Financial Services (PFS) submitted a claim for the patient’s maternity visit to the insurance carrier the patient originally providedThe insurance provider paid the claim, the patient paid her portion and the account was paid in fullSubsequently, PFS was notified by the insurance provider that paid the claim that they were recouping their payment because a different insurance carrier was the primary payerPFS billed the patient’s other insurance carrier however the claim was paid incorrectlyAs a result, PFS had to send an inquiry to both insurance carriers in order to be assured there would be no further recap of payments or adjustments prior to releasing the refund to the patient since both payments had a large out-of-pocket expense for the patientTypically this process takes insurance carriers approximately days to provide an updateTo date we have not received confirmation from either insurance company that no further adjustments will be made, however in the interest of patient satisfaction we are releasing a refund of $1,as a credit to the patient’s credit cardPlease be aware that if either or both insurance carriers make any payments corrections after the refund is issued, the patient will be billed for any new patient balance dueAdditionally, PFS responded to the patient in writing outlining what occurred in this case, advising her that we have responded to your agency and that the matter is resolved and closed at this timeHard copy letter will be mailed to Revdex.com via certified mail

Patient Financial Services (PFS) submitted a claim for the patient’s maternity visit to the insurance carrier the patient originally provided. The insurance provider paid the claim, the patient paid her portion and the account was paid in full. Subsequently, PFS was notified by the insurance...

provider that paid the claim that they were recouping their payment because a different insurance carrier was the primary payer. PFS billed the patient’s other insurance carrier however the claim was paid incorrectly. As a result, PFS had to send an inquiry to both insurance carriers in order to be assured there would be no further recap of payments or adjustments prior to releasing the refund to the patient since both payments had a large out-of-pocket expense for the patient. Typically this process takes insurance carriers approximately 60 days to provide an update. To date we have not received confirmation from either insurance company that no further adjustments will be made, however in the interest of patient satisfaction we are releasing a refund of $1,324.80 as a credit to the patient’s credit card. Please be aware that if either or both insurance carriers make any payments corrections after the refund is issued, the patient will be billed for any new patient balance due. Additionally, PFS responded to the patient in writing outlining what occurred in this case, advising her that we have responded to your agency and that the matter is resolved and closed at this time. Hard copy letter will be mailed to Revdex.com via certified mail.