Can a medical billing company reimburse a provider for errors

by beverly
(texas)

My question is, if several charges for a date of service were not filed in time due to not seeing the superbills for that day would a medical billing company need to reimburse the medical provider even though the provider said she was going to write off the late penalties and deduct it as a loss on her taxes?

Beverly E.

I don’t see how the billing company could be responsible if they didn’t receive the superbill – unless there is some sort of stipulation in the contract that the medical billing service company has with the provider.

If you have anything in writing it would be very helpful in this sort of situation. I know of situations where a provider has said one thing and – like you mentioned the intent of the provider to write-off the charges – but later forgot they told the billing company – or there was some other sort of misunderstanding.

With the situation you mentioned it almost sounds like the provider is upset with the medical billing service for not filing the claims – and expects them to “make up” for the lost income.

However if the amount of reimbursement we’re dealing with here is not large, this is a good client, and you have so far had a good working relationship with them – I would consider refunding the charges.

I had a similar situation with a provider where there was a misunderstanding over co-pays and I just credited the amount back to them because I wanted to keep their business and the amount in question wasn’t significant in the whole scheme of things.

I hope I answered your question – Thanks,

Gina

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