Provider Will not Return Overpayment (In Network)

I had surgery with an In Network Provider after hitting my OOP Max. For the consultation I was asked to pay out of pocket for the consultation and was told I would be reimbursed after insurance paid. Okay, no problem, this is pretty common and I rarely have issues with this… so I paid their fee on the date of service.

They didn’t submit that claim right away which was annoying but after surgery I ended up getting a bill for about $2500. My EOB’s all stated “Amount Owed $0” so I complained several times saying “Aetna is telling me I owe $0” to which they responded “there are still pending claims, this is just your balance right now, we will refund you when everything is sorted out.” I refused to pay this for a long time but then they were threatening to send me to collections so mistakenly, I paid. Then those claims went through and sure enough, Aetna paid at 100% of the billable rate.

I have been extremely reasonable with talking to the billing office at the providers office (they are “never available”… examples: “on vacation”, “with another patient”, “on the phone with an insurance company”, etc) and they say they will call me back but conveniently “forget”. Since they’re In Network, Aetna should be able to help me but this is just not the case. Not surprisingly, this ALSO occurs when Aetna tries to help me resolve the issue!! Nobody ends up following up with it and I have to start over with a new rep! This has been now ongoing for months…

I’ve directly asked the practice (and have proof of these instances) “What are the services I received that I was to owe money for, if some existed and I’ve simply made a mistake and did owe that money, I am happy to leave you alone.” They either do not reply to the email or do not call me back.

I’ve also tried submitting grievances to the complaint department at Aetna but there was no issue with the way the claim was processed…. It was processed correctly it’s just the providers office that can’t see that (I have even sent them copies of the EOB’s which state I owe $0…. ).

What can I do? Anything? There’s small claims, but this is further complicated by the fact that I am a pre-med student and the surgeon teaches at my primary choice of medical school. Unfortunately, I would have to fear retaliation in the form of not being accepted there (even though that’s illegal… but so is stealing $2,650 from a college student for no reason….)

And is the ignoring tactic common?? I’m finding it very strange… why let the issue linger?? Are they just hoping I get tired so they can keep the funds? I did pay with credit card also.