my former primary dental insurance has a set contract rate of $433 for a root conduit and they paid 80% which leaves a go together of less than $90. the dental organization submitted my Explanation of benefits to my secondary insurance (at that time, but is immediately currently my primary) and they paid over $500 on that claim. I notify my former primary and they said that they will be requesting a refund to me since the dental bureau received appr. $400 profit since they are not allowed to take more than the contracted service charge and are in vandalism of their contract. so when i get this money posterior from the endodontist should i give it posterior to my primary who was at the time my inferior or should i keep it for myself? i hope this wasn't too confusing. i hold already notified my lower who is now my primary of the overpayment but they don't protection and has cause me to max out due to the overpayment.
Answers: The dentist,as far as I can see, did not violate his contract by accepting the secondary's erroneous payment. Obviously, the insurance made an error.The dentist's department will (if their billing dept is up to snuff) contact the insurance that paid subsidiary (since they obviously remunerated incorrectly) and the secondary will request a settlement, which the dentist will have to dispatch once he gets the written request from the insurance co. Your dentist will not compensation anything directly to you...
Bank it but do not spend it. The ins. company will come looking for it Happen to me, two years later they needed the overpayment and I gladly sent it and kept the interest earn.
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Answers: The dentist,as far as I can see, did not violate his contract by accepting the secondary's erroneous payment. Obviously, the insurance made an error.The dentist's department will (if their billing dept is up to snuff) contact the insurance that paid subsidiary (since they obviously remunerated incorrectly) and the secondary will request a settlement, which the dentist will have to dispatch once he gets the written request from the insurance co. Your dentist will not compensation anything directly to you...
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Bank it but do not spend it. The ins. company will come looking for it Happen to me, two years later they needed the overpayment and I gladly sent it and kept the interest earn.
Resolved Questions: