Stealing Insurance Money

[mccabal]

I work in medical billing for a private company. Often, when we submit a claim on behalf of a patient, the insurance company pays the patient directly rather than my employer (the provider). What is supposed to happen, obviously, is that the patient then pays my employer or simply signs over the check. Unfortunately, there are several individuals who think this is "free money," cash the check and never pay my employer for services rendered.

Since these people are literally stealing $ from us, what are our recourses for recovering the money? I have called these people sometimes for months and months and they refuse to pay. Is this a job for collections? Small claims court? The amounts owed typically fall in the $1000-$2000 range.

Please advise.

Thank you.

 

[Rathi]

I wouldn't say they are "stealing" your money, cause it's not your money, until they pay you.. hehe They may very well owe your company that money, but... anyway....

I would consider contacting maybe the insurance company about the problem. I'm really not sure how far that will get you, because the person(s), should be forwarding that payment on to you. I guess the insurance comp. would actually be out of the loop, cuz they've done what they are supposed to...

I would assume that collections would then be your next step, I really can't think of what else you may do to the customers........

Basically, once the insurance pays out, it's out of their hands, and it is the individual's responsablity to pay up...

 

[Michael Wechsler]

Question -- do you have your patients assigning the right to the insurance proceeds over to you before treatment?

This can be a nightmare with regard to collection. The amount owed is small and is a small claims case. However, going to court, obtaining a judgment, filing a lien and executing on the judgment (if the patient doesn't pay) can be a hassle and an expense greater than the amount owed.

Originally posted by mccabal
I work in medical billing for a private company. Often, when we submit a claim on behalf of a patient, the insurance company pays the patient directly rather than my employer (the provider). What is supposed to happen, obviously, is that the patient then pays my employer or simply signs over the check. Unfortunately, there are several individuals who think this is "free money," cash the check and never pay my employer for services rendered.

Since these people are literally stealing $ from us, what are our recourses for recovering the money? I have called these people sometimes for months and months and they refuse to pay. Is this a job for collections? Small claims court? The amounts owed typically fall in the $1000-$2000 range.

Originally posted by Rathi
I wouldn't say they are "stealing" your money, cause it's not your money, until they pay you.. hehe They may very well owe your company that money, but... anyway....

I would consider contacting maybe the insurance company about the problem. I'm really not sure how far that will get you, because the person(s), should be forwarding that payment on to you. I guess the insurance comp. would actually be out of the loop, cuz they've done what they are supposed to...

I would assume that collections would then be your next step, I really can't think of what else you may do to the customers........

Basically, once the insurance pays out, it's out of their hands, and it is the individual's responsablity to pay up...