Denied Claim Reversed, But After I Already Paid – What Happens Next?

Ended up in the hospital last year for 4 days (fluid around heart and lungs, but ultimately no diagnosis of what it was).

Have BlueCross and everything was approved except for the ambulance drive from the urgent care place to ER.

It was $3k+ out of pocket.

Went ahead and filed an appeal and finally today received a letter saying they have revered the decision and will now pay based upon the proof I provided that the doctor called for the ambulance and did not want me to drive myself.

Great news, but I had already paid as I did not want the bill to go into collections (had already received 2 notices from the city about the bill before then while I had hoped this would resolved).

I ended up paying it off about a month ago if I remember correctly.

How does a situation like this usually play out? Will they try to pay it directly to the city and find out it has been paid for? Will I file another claim and they will cut me a check? Something else?

I’m going to be calling them on Monday morning to discuss as claims isn’t open on the weekend, but was curious if anyone has been in a similar situation before and what happened?

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