Do I need to repay overpaid health claim?

[rebecca01]

What is the name of your state (only U.S. law)? Iowa

My HMO plan (through my company's group benefits) overpaid some claims to me. I submitted claims for out of network chiropractic care, and they reimbursed me. This continued for a few months. Then one day, my claims started to be denied. I called the company and inquired why this was, and said that if they looked at my records I had been reimbursed for the same treatment by the same provider for the past few months. I was told that those claims should not have been paid, and that they were going to look in to them. I jokingly said something to the effect of, "If I hadn't called, nothing would have happened, right? So I guess I would have been better off not calling at all." I was given a somewhat affirmative response. Soon after, I received a bill in the mail asking me to repay the overpaid monies.

This doesn't seem right to me, but I don't know if I have any ground to stand, or if I just need to go ahead and repay them. The repayment amount isn't huge, but it's enough to cause a pinch in our family's budget, especially when I received the payments in small increments, and am now being asked to repay in one lump sum. Can anyone offer any advice?

[Zigner]

Originally Posted by rebecca01

What is the name of your state (only U.S. law)? Iowa

My HMO plan (through my company's group benefits) overpaid some claims to me. I submitted claims for out of network chiropractic care, and they reimbursed me. This continued for a few months. Then one day, my claims started to be denied. I called the company and inquired why this was, and said that if they looked at my records I had been reimbursed for the same treatment by the same provider for the past few months. I was told that those claims should not have been paid, and that they were going to look in to them. I jokingly said something to the effect of, "If I hadn't called, nothing would have happened, right? So I guess I would have been better off not calling at all." I was given a somewhat affirmative response. Soon after, I received a bill in the mail asking me to repay the overpaid monies.

This doesn't seem right to me, but I don't know if I have any ground to stand, or if I just need to go ahead and repay them. The repayment amount isn't huge, but it's enough to cause a pinch in our family's budget, especially when I received the payments in small increments, and am now being asked to repay in one lump sum. Can anyone offer any advice?

Seems to me that you would have been better off not calling them at all

You owe the money - pay it back.

[justalayman]

rebecca01;1996418]This doesn't seem right to me,

So if you accidentaly overpaid for something, you believe that party has a right to keep the money? I think there is not only a legal problem here but one of morals as well. They overpaid you due to a mistake and all they want is the money you should not have received and now you are trying to figure out how to keeo the money. WOW!.

or if I just need to go ahead and repay them.

Do you really need somebody to answer this?

The repayment amount isn't huge, but it's enough to cause a pinch in our family's budget,

It is not their fault for your finanical problems. They are not trying to injure you but you are trying to injure them.

Can anyone offer any advice?

Yes. Pay them back the money. If you cannot afford to pay them all at once, ask if you can make payment arrangements. It doesn;t hurt to ask.

[ecmst12]

I suggest you review your policy in detail to see if you really were overpaid. If you were, you will have to repay them, but they will probably be willing to work out a reasonable payment arrangement with you.