Pennies from heaven?

July 14, 2012 1:40 PM

I had a routine ladyparts exam a few months ago. It qualified as "preventive care" and I didn't have to pay a copay. (Yay! Thank you, ACA!) I got a rundown of what they charged my insurance a month or two ago -- one of those THIS IS NOT A BILL things -- and promptly lost/forgot about it, since I owed nothing. Today I got a check, made out to me, from the doctor's office for a couple hundred bucks. Do I get to keep it?

I know that I can find this out on Monday morning, but there are bills to be paid and it would make me really happy to know now if this is a standard thing, what might have happened, if I'm going to have to pay back either the doctor's office or the insurance company, etc.

I don't know if it matters but this is my own private insurance plan, not through my work.

posted by fiercecupcake to work & money (10 answers total)

I can't imagine a situation where you get to keep this check. You didn't pay for services, and the office didn't charge you for services. If the office overcharged by accident then the check belongs to the insurance company since they're the one who paid.

Or maybe the office just printed the check in error and they haven't realized it yet.

Sorry, but unless there are more details this money simply isn't yours to spend.
posted by sbutler at 1:54 PM on July 14, 2012 [2 favorites]

Call the doctors office before cashing the check.

Same thing happened to me - and I didn't call the office. I cashed the check instead. A few months after that, I get a bill for the amount of the check they sent me. I paid it, but it w a rude awakening.
posted by spinifex23 at 2:03 PM on July 14, 2012 [1 favorite]

I can't imagine how you could legitimately end up with a $200 credit balance from an encounter where you didn't pay anything. It seems much more likely that they really owe the balance to your insurance carrier, but it got accidentally moved over from an insurance balance to a patient balance - patient accounting gets screwed up like this all the damn time.

On the other hand, if this is a doctor you've been seeing for a while, it could also be refund from some other encounter where they miscalculated your liability and over-collected from you, and are just now figuring it out, even if it's years later - patient accounting also gets screwed up like that all the damn time.

The most honest thing to would be to call up your doctor's billing office on Monday and ask them why you ended up with the refund. If you do want to just cash the check and hope it's legitimate or they don't notice the error, you wouldn't get in any trouble, but you would have to pay them back if they figure out the money's not yours.
posted by strangely stunted trees at 2:05 PM on July 14, 2012 [4 favorites]

I got a refund for the copay for my last yearly physical at my doctor, since it had taken place after that bit of the ADA went into effect but before they had sorted out the billing on their end. But that was a copay - $15, maybe? - not any substantial sum. I agree with everyone else that you need to assume this is not your money until you talk to the office.
posted by restless_nomad at 2:31 PM on July 14, 2012

OK! Don't worry, y'all -- I was not in any way assuming I'd get to keep it, just hopeful. I've been overpaid in other circumstances and had to pay it back, so I'm leery about this sort of thing.

I have been seeing this office for years, and I did pay quite a bit of money out of pocket for a procedure last year that I thought should have been covered, so I guess there's still a little hope there. I thought there might have been some weird thing I was overlooking. I'll just have to wait till Monday to find out!
posted by fiercecupcake at 2:46 PM on July 14, 2012

I agree it could be from an older date of service. You'd be surprised how long it can take to correct stuff! That seems more likely to me than turnaround on something a few months old. Hope the cash is yours.
posted by ThePinkSuperhero at 3:19 PM on July 14, 2012

Yeah, just call the office. They'll be able to work it out pretty quickly.
posted by valkyryn at 4:41 PM on July 14, 2012

You may get to keep it; there was some kind of setup with my son's physical therapy where, after 4 months of weekly copays, they reimbursed me the copays and didn't charge me for the rest of his visits for the year. The office and the hospital it was affiliated with both insisted it was fine; my insurer had no idea what I was talking about. I assume that it was either a shady kickback thing or just really inefficient billing or contract weirdness. No one ever demanded the money back, and he's been out of PT for a few years now, so...whatever.

Medical billing is crazypants.
posted by emjaybee at 6:21 PM on July 14, 2012 [1 favorite]

Well, definitely cash the check, if it's made out to you.

Just be aware there may also be a $200 bill - also made out to you - coming your way.

But I would say just cash it (it is not like you can hand the doctor's office a check that's made out to you, well, without potential long-run problems) and just wait for them to bill you.

I had this same thing happen with a gasto surgeon a while ago for $600.
posted by Lt. Bunny Wigglesworth at 10:27 PM on July 14, 2012

All right, y'all, I finally had a chance to call during business hours, and...

I get to keep it! It was from that procedure last year that I had to pay out of pocket for. It turns out the insurance company covered it after all, and almost a year and a half later I'm getting my money back.
posted by fiercecupcake at 8:19 PM on July 19, 2012