What can I do when a doctor is holding my insurance refund money?

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What can I do when a doctor is holding my insurance refund money?

I went to a new doctor for a physical and they told me their policy was for patients to pay upfront and they would bill the insurance and then send me the insurance refund. My insurance paid them about 2 months ago and they told me the check would be sent at the end of April. Now they are telling me that they are holding the refund until my insurance pays for a follow up visit (I already paid my co-pay and fulfilled my obligation). They will not let me speak directly with the billing department.

Asked on May 29, 2009 under Insurance Law, California

Answers:

L.M., Member, California Bar / FreeAdvice Contributing Attorney

Answered 12 years ago | Contributor

First, your refund should have been sent to you, not to the dr. if you had already paid the bill, and your dr.'s office should have so informed the insurance company.  If you have paid the bill in full, and the dr.'s office refuses to reimburse you after having received the check from the insurance company, and they acknowledge that they have the check, I would call and ask for the billing department.  If they do not allow you to speak with them, which I cannot imagine could be the case, call and leave a message for your doctor and for the office manager, and call your insurance company.  They are likely violating their contract with the insurer.  If, after all that, you still get no satisfaction, call an attorney in your area to call them and/or write a letter, and I'm sure you'll get your money.  The only thing is, it will cost you an attorney's fee, so if you have an attorney friend or relative willing to do it for nothing, that would work best.


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