Claim processed wrong – in my favor. Do I point out the mistake or ignore it?
In a rare turn of events, Anthem processed a claim incorrectly, but it benefits me instead of them. Over the past few months, I've regularly been submitting manual claims for an out-of-network service that I pay for out of pocket. Previous claims have been marked as contributing towards my deductible for my HDHP plan. I have not hit my deductible or out of pocket max for my plan yet, but my most recent claim was marked for full reimbursement to me (plan pays 100%, doesn't contribute to deductible/OOP max at all).
I'm not sure what to do here. I'm tempted to do nothing – I will be submitting more claims like this for the rest of the year, and this service will eventually be fully covered once I do hit the OOP max (amount billed is fully allowed by my plan). If they process future claims correctly, I'll easily hit my deductible/OOP max, just slightly later than I thought I would this year; then I'll be getting reimbursed anyway.
If I want/need to correct this issue, sooner would probably be better because the reimbursement deposit isn't supposed to hit my bank account until tomorrow. There's a chance I could reverse it before it gets to me, and that seems easier than Anthem trying to claw money back later.
Thoughts?
submitted by /u/jennarallyspeaking
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