Patient Refunds for Untimely Filing

May 1, 2008

If a claim is to be written off due to lack of timely filing and the patient has made payments against the claim, is the patient entitled to a refund for the amount they have already paid?

Question: If a claim is to be written off due to lack of timely filing and the patient has made payments against the claim, is the patient entitled to a refund for the amount they have already paid?

Answer: Let me make sure I’m clear: The claim ought to have been paid by a payer, but was filed too late. For some reason, the patient was also paying against the claim.

If this is the case, then yes, the patient needs a refund. She should not have been paying in the first place and the fact that her payer didn’t cover the expense is the fault of the medical office, not the patient.