Refiling Claims

July 1, 2005

We've been seeing a Medicare patient for about a year. She pays the required copays/deductibles out of her pocket. Well, she just informed us that she also has another insurance carrier. She wants us to go back, rebill all her claims with this payer, then refund for what she paid out of pocket. Do we have to do this? Can we charge her for doing it? It’ll take quite a bit of time.

Question: We've been seeing a Medicare patient for about a year. She pays the required copays/deductibles out of her pocket. Well, she just informed us that she also has another insurance carrier. She wants us to go back, rebill all her claims with this payer, then refund for what she paid out of pocket. Do we have to do this? Can we charge her for doing it? It'll take quite a bit of time.

Answer: Honestly, I would ask the patient to submit the claims herself. Filing any claim is a courtesy we give our patients. It's her money. It will cost you to do the research and paperwork, and Medicare will frown on you charging her for doing it.

You can offer to help her find and understand the right forms, but she'll need to fill them out and send them in herself. The payer can reimburse her directly.