I work in the medical field as a certified surgical assistant. I am compensated from insurance companies. There is one insurance company tha...

Question

I work in the medical field as a certified surgical assistant. I am compensated from insurance companies. There is one insurance company that will mail any money due to me for my services directly to the patient (normally other insurance companies will just mail a check directly to me). The patient in return is to mail me a payment. My billing service notifies the patient in advance of this and explains what is to be done when they receive payment for my services. A few years ago I started using a collection agency as many of the patients for what ever reason were not sending me a payment after receiving a check from the insurance company. After numerous attempts on my billing services part to obtain my payment, it is then sent to collections. At end of last year the collection agency I used had gotten a payment from one of these patients. The amount collected was $581.04. After the collections fee I was mailed a check for $377.68. A few months later the insurance company said that they had made a mistake and no payment should of ever been sent to me and is demanding the full amount of $581.04 back. I sent a letter back to insurance company telling them that I only got $377.68 from the collection agency and to check to see that it was not a mistake and the payment was meant for me. Two months later I was sent notice stating that this matter was sent to collections.

My question to you is where do I stand on this? Am I obligated to send back any money collected on this even thought no payment was ever directly sent to me from the insurance company as it went directly to the patient? Also I did not receive the full $581.04.

Thank you,

Anthony

Answer

Short answer is yes... if there was a billing error or payment error... you are responsible for the full amount for repayment... you should go after your collections company for the amount they held back for their payment. Your relationship with the collections agency is separate from your relationship with the insurance company and patient.