How many times can an insuance company reprocess a claim?

by lordandlife7 » Wed Nov 12, 2008 02:38 pm

I work for a dr. in Ohio. We are having a problem with an insuance company. How many times can an insuance company reprocess a claim? We have a specific group of patients that have been processed no less than 3 times for a specific group of dates of service. I have a pile of 100+ pages of mess. Every week I get a new EOB with a new problem. They take back money they have paid, combine services, reprocess and then sometimes pay again incorrectly. So then that creates a traking/paperwork nightmare! I have no idea what to do and how to handle this. I have called my provider rep and she says that they have it taken care of. It started because they processed two units as only one...then this snowballed into reprocessing with correct 2 units. Accidentally paying too much on some patients, then reprocessing again taking back other services on same day (saying they were secondary to primary procedure) then processed again as duplicates and so on...Such a mess. Now they are going back up to 2 years ago so far and reprocessing again creating themselves an accounts receivable. If you can help....please do.

Total Comments: 11

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