Before Cardiology Medical Group processes a refund, all dates of service must be paid by the insurance company. The following are reasons why:
•The patient's insurance has termed, and they neglected to tell you. In this case, you can use the "overpayment" and apply it to any outstanding charges the patient has incurred.
•The insurance denies a claim, and you still have the "overpayment" that you can apply to that date of service.
•The insurance company reverses a charge either from your office or another physician resulting in the patient's deductible or out-of-pocket now not being completely met. This means that the "overpayment" can now be applied to the date of service you have outstanding, and you do not have to use your resources to bill the patient again.
Always communicate with your patient when there is an overpayment. Investigate it thoroughly, and explain to the patient that if they can make a few phone calls to the insurance company, it will help move the insurance payment and their refund more quickly. This will allow you to release any overpayment that there might be. The patient is the insurance company's customer and want to keep them happy, so asking the patient to step in and help get you paid is a great tool to utilize in situations like this.
Cardiology Medical Group issues refunds within 60 days of determining a refund is due.