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CMA - California Medical Association

California Physician's
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Reimbursement: From Private & Public Payors
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Plan Requests for Refunds from Physicians

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Document: 7512
Chapter: Reimbursement: From Private & Public Payors
Pages:
11

  • Insurance/Reimbursement
  • Legal Issues
    Payor Issues
  • Legal Issues
    Payor Issues
    Reimbursement

The following is an introduction to the document. To download the full text of the document, please log in.

Physicians often contact CMA because managed care plans ask them to return monies allegedly overpaid on their claims. We understand that thousands of physicians have been unfairly asked to return payments at one time or another. These physicians are rightfully upset, because they do not feel that the requests are justified and they resent the amount of time that dealing with the inappropriate requests exacts on their practices. Such requests for refunds may also be illegal, as is discussed below. This discussion addresses some of the frequently asked questions regarding what to do when a payor is alleging it overpaid you and is requesting a refund.

Keywords:

  • CMA On-Call
  • Managed Care
  • Reimbursement
  • Unfair Payment Practices

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