Collected refunds for copayments/overpayment at 4 different facilities. I can’t get an answer from anyone.
● The first time I went to a regular doctors office, I went in thinking there was no copay. The lady asked me for $25. I paid it, but then I double checked and saw only urgent cares have that co-pay. I went up and asked her if this was an urgent care, she said no. So I asked for the money back but I had to wait a month.
● Next, I went to a pharmacy, got two medications & then read my EOB. The amount I should’ve paid was lower…so again, had to go back and collect $5.
● I went to the ER, I paid $400 copay. I wasn’t 100% sure what it was b/c of the wording on my benefits app but the receptionist just agreed with me that this is what I would owe. I got my EOB back and I actually owed nothing! So I’m currently waiting to collect there. The reason I was confused is b/c it says 2 different things about ER visits in my benefits app. One place it says ER in/out network “400 copay” and another “400 copay after deductible”. I have screenshots. I actually thought I was going to owe. I called my insurance to clarify, they say it is the latter from what they can see. But no one can tell me why I’m seeing two different things, I was told to call my HR department lol. In the end, though, everything was miraculously covered b/c it was labeled as COVID related.
● The 4th incident was at my gyno. I went in for a follow up on a pap smear I had & a few other things. They collected a $55 copayment for “specialist” doctors. My insurance failed me here because it doesnt detail what specialist means. I’ve looked on the old paperwork I had from last year (which is ni longer available online, go figure). I told them that ice been having issues with doctors offices collecting co payments that werent owed to them but they were very confident. I wasn’t but I paid it. I was more worried about being refused services.
I checked my EOB for this visit & again…I did not owe anything. The insursnce agent told me the coded it as a normal doctors visit, not a specialsit one.
All of the other times the receptionists were just guessing, it wasn’t clear to them. They didn’t know what my insurance was, never heard of it (it’s a BCBS hmo plab). I found out from an insurance agent that my specific plan is only 1yr old.
I’m inclined to be upset with the doctors offices b/c they are so non-chalant about it. “Oh well just bill your insurance and see.” But at this point I can tell they are genuinely confused and so am I.
When i spoke with the last insurance agent, I kept asking what I could do to protect myself so I dont have to keep collecting payments, but she couldn’t give me a straight answer.
All I know to do is to ask the office to bill my insurance first, but I’m worried I won’t be serviced. I’m also worried about these refund checks, if it goes over a certain amount and I have to report it as income??
