Blue Shield asking me to send them money for settled claim

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What is the name of your state? California

Blue Shield of CA settled 6 different claims last spring, refunding to me a total of $899.49. Later, they reviewed these claims and decided to deny the claims because the service was for experimental treatment, which is not a covered service. They just wrote me yesterday asking for a payment for this total in the next 30 days. By law am I obligated to pay this amount?

 

[lealea1005]

If it is clearly stated that it is not a covered serivice then yes, unfortunately, you are obligated to pay them back. Sorry

Actually, they just did this to our practice due to their error in the way they covered services for a patient of ours. They took back payments that were over 2 years old by debiting payments they should have been sending us for other patients!

 

[Job_Hunting]

I have copies of a few rulings stating something to the effect that if it is the insurance companies error and no one was intending to "defraud" the company, that the error is the responsibility of the insurance company, not the practice. I will have to dig those out and post them to see if they will be helpful or relevent in your case.