Recoupment of payment (Insurance Companies)

Does anyone know the time limits and/or restrictions for insurance companies recoupment of payments? I am noticing United Healthcare and a few other insurance companies recouping payments from claims that are seven plus years old. Where can I find this information?


Tiffany M. Burns
Billing Manager
Nephrology Associates of Mobile PA
PO Box 850849
Mobile, Al 36685
(251) 343-5004 ext 6972
Direct Line: (251) 300-6972
Fax: (251) 343-5136
tiffany.burns@nephrologymobile.com

Comments

  • State and federal laws may vary.
    I understand that CMS has 3 years from date of service to demand refunds.
    Commercial contracts may provide for a longer term, but 4 years is not
    unusual.
    Individual payer contracts may have other wording.
    I would check with your state Insurance Commissioner for non-CMS insurances.
    I'll try to find the CMS limitation next.
    Stand by.
    Bob O.

  • It depends on your state I know in CT it is 5 years!!!



    Although I only have a year for Medicare and much less to get my claim into the payers! I have a list by state somewhere I will try to locate it for you.



    Renee R. Antonetti, CPC, CHCO
    Director of Revenue Cycle Management
    Certified Hipaa Compliance Officer
    Alliance Medical Group
    1625 Straits Turnpike, Suite 201
    Middlebury, CT 06762
    Phone: (203) 573-9512 ext. 2346
    Fax: (203) 568-2904
    rantonetti@alliancemedicalgroup.com




  • I wish we had the same amount of time for appeals. The rules are so unfair.

    Cindy Terry, CENTC
    Certified ENT Coder/Reimbursement Manager

  • edited May 2017
    Of course, the contract doesnt matter if its an ERISA claim.

    Don Self
    office 903 372-7529
    iPhone: donself@donself.com
    www.donself.com


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