Can my insurance force provider to refund incorrect charge?
Brought my son to in-Network urgent care that has not been sending the claim correctly to my insurance, despite multiple attempts on my end and my insurance’s end to resolve this. At the first denial, they charged the debit card I used to pay the copay at time of visit, the insurance’s portion and won’t refund. It’s been over 4 months of back and forth. My EOB states I do not owe and that provider isn’t sending to the right BCBS. A lot of escalation and complaints, my insurance followed up with me again today (they can’t get provider to cooperate either):
“Please be advised that an outreach call was made to the provider to educate. We have provided the mailing address for claims and the payor id number for electronic submissions, again. The provider agreed to resubmit the claim.
The provider did not agree to refund the additional $150.00 that was charged to your credit card. The provider stated they will refund after Independence pays the claim. We are in the process of generating a letter to the provider to refund you all funds charged to your credit card.
Again, we can not process the claim until the provider submits it directly to Independence.”
It looks like my insurance is forcing them to refund the amount, hopefully they can! What a headache this is. I’ve had similar issues where an urgent care incorrectly submits a claim but never auto charged me, they usually apologize and tell me to disregard bill, follow instructions and resubmit correctly.
Unfortunately, it seems like you can’t be seen anymore without providing a payment card. This was MedExpress in Altoona, PA FYI. They’ve never been eager to correct the claim issue most likely because they already got paid. The total amount they got from me was higher than self pay too! Seems sketchy!!!
submitted by /u/No_Panda_9171
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