Crazy CMC refund policy (insurance, credit, adjudication)

[gkleoni1]

This week I have spent almost 2 hours on the phone trying to get $292 back from CMC. Between my daughter's minor out-patient surgery in March and mine in May we wound up over-paying, by the request of the admitting person, by $292. At the time I thought "no big deal we just need to stay on top of it".

So I was informed that when there is a credit on an account they do not refund the money until all pending charges for all CMC services are reconciled by the insurance company. So I told them that we pay our co-pays at the time of service and that between my husband, daughter & myself we pretty much see some CMC doctor regularly. I had to do the whole "speak to a supervisor" thing and finally got "approval" to get my own money back.

It is the most absurd policy I have ever heard of. Maybe I could understand if they had record of us not paying our bills or having sent us to collection but that is not the case. I told them it was like handing a store clerk a $20 and him saying, "you come here a lot so I'm going to keep your change just in case you need it next week". So FYI - do NOT over-pay (no matter what they ask for when they admit you) when dealing with CMC or they may keep your money in perpetual hold!!

[anifani821]

I am dealing with hospital bills from CMC myself right now. I feel like Alice Through the Looking Glass . . . so I know what you mean - and why you are frustrated.

Sadly, this is not unique w/ CMC, tho. It seems everything to do w/ finance is difficult when dealing with any healthcare entity these days. You did the right thing by going up the ladder, but it really is absurd that we consumers have to fight to get money back that we are clearly owed!!!

Try to dispute billing with a hospital (any hospital!!!) You don't even wanna know . . .

I just try to focus on the fact that we did feel we received good medical care while at the facility. I would be truly livid if we hadn't - and were getting messed with in re: to charges on top of it.

[chicagocubs]

My problem has been when I have paid a co-pay at the hospital ER or whatever, that they don't actually credit my account. SO, then there is the wrangling for months with them wanting more money when it was actually paid!!

[victor123]

From the time of registration to the time of full adjudication (ie bill is paid 100% or to the contractural percentage) within the healthcare industry is anywhere from 45 to 50 days. You paid your co pay on day 1 and request a refund on day 15, yet the payer has still not responded from the initial claim. Theres no telling what your insurance will actually cover to what was billed. The entire process is a huge balancing act controlled by the payers directly. This is without a doubt not the doing of the provider, but rather the insurance company. As a provider, i would want to be paid the next day for services rendered, but this is not feasable, hence the policy to wait for the insurance company to respond (~45 days).

[gkleoni1]

Originally Posted by victor123

From the time of registration to the time of full adjudication (ie bill is paid 100% or to the contractural percentage) within the healthcare industry is anywhere from 45 to 50 days. You paid your co pay on day 1 and request a refund on day 15, yet the payer has still not responded from the initial claim. Theres no telling what your insurance will actually cover to what was billed. The entire process is a huge balancing act controlled by the payers directly. This is without a doubt not the doing of the provider, but rather the insurance company. As a provider, i would want to be paid the next day for services rendered, but this is not feasable, hence the policy to wait for the insurance company to respond (~45 days).

The 2 surgeries have already been paid. What CMC is doing is holding the overpayment from the 2 surgeries until BCBS processes my weekly physical therapy appointments which have nothing to do with either surgery but the office happens to be in the Carolina's Healthcare System network. Infact they told me they will hold the overpayment indefinitely as long as any of their Network Drs. show a pending charge for either my husband, daughter or myself. Really no justifying what they are doing. I was fine waiting until the to surgeries were fully paid but this is absurd!