Insurance payment for late cancelled appointment, How do I refund them?
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I submitted my first batch of insurance claims for a client and one of the sessions was a late cancel but the CPT code had not been changed and was listed as 90837.  The insurance company paid the claim.  How do I correct this?  Can I re-submit the claim?  How do I refund the money?

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    Nora

    Hi Tami,

     

    My name is Nora and I'm an Insurance Specialist here at SimplePractice. I'll be happy to help with this.

     

    I understand that you marked an appointment as Late canceled after a claim was already created in your SimplePractice account. The claim was then submitted and the insurance company processed and paid for the appointment incorrectly.

     

    In this case, I recommend that you contact the payer directly to let them know that a claim was submitted in error. The process for voiding an incorrectly paid claim will vary from payer to payer, so working with a live representative will ensure that you have the correct requirements for this particular payer.

     

    During this call, you can reference the claim using the client's name, member ID, and dates of service or using the Payer Claim #. 

     

    If the payer requires a voided/cancelled claim to be submitted, request the original claim number. This number will come directly from the payer and will need to be listed on a cancelation claim.

     

    To create a cancelation claim, you will want to:

     

    1. Open the claim that was submitted in error and click Edit to Resubmit.
    2. Scroll down to box 22 and select Cancellation. Please note that when you submit a claim electronically through SimplePractice, (you do not need to include a frequency code).
    3. Enter the claim # provided by the payer in the Original Ref. Number field.
    4. Next, click Save and Submit.

     

    Each payer will also have varying processes in place for returning the original payment. Some will allow you to keep the payment and will put it toward future claims. Though, others may request that you return a check to them by mail. You will want to work with the payer to determine what method they use.

     

    Please let me know if you have any follow up questions for me after speaking with the payer. We're always happy to help and I would be glad to continue working with you.

    Hi Tami,

     

    My name is Nora and I'm an Insurance Specialist here at SimplePractice. I'll be happy to help with this.

     

    I understand that you marked an appointment as Late canceled after a claim was already created in your SimplePractice account. The claim was then submitted and the insurance company processed and paid for the appointment incorrectly.

     

    In this case, I recommend that you contact the payer directly to let them know that a claim was submitted in error. The process for voiding an incorrectly paid claim will vary from payer to payer, so working with a live representative will ensure that you have the correct requirements for this particular payer.

     

    During this call, you can reference the claim using the client's name, member ID, and dates of service or using the Payer Claim #. 

     

    If the payer requires a voided/cancelled claim to be submitted, request the original claim number. This number will come directly from the payer and will need to be listed on a cancelation claim.

     

    To create a cancelation claim, you will want to:

     

    1. Open the claim that was submitted in error and click Edit to Resubmit.
    2. Scroll down to box 22 and select Cancellation. Please note that when you submit a claim electronically through SimplePractice, (you do not need to include a frequency code).
    3. Enter the claim # provided by the payer in the Original Ref. Number field.
    4. Next, click Save and Submit.

     

    Each payer will also have varying processes in place for returning the original payment. Some will allow you to keep the payment and will put it toward future claims. Though, others may request that you return a check to them by mail. You will want to work with the payer to determine what method they use.

     

    Please let me know if you have any follow up questions for me after speaking with the payer. We're always happy to help and I would be glad to continue working with you.