2002 Refund Request by ins
Medicare - 1st InsHMO/Capitation - 2nd Tricare for Life - 3rdDOS: 2002TFL paid a claim back in 2002 after Medicare..(Medicare fwd claim to TFL). I cannot tell if the biller at that time billed the 2nd...
View ArticleRe: 2002 Refund Request by ins
Inform Tricare that(1) Waiting three years to demand a refund is unfair, prejudicial and places an undue burden on you.(2) Inform them that the practice is no longer in business and cannot refund...
View ArticleRe: 2002 Refund Request by ins
Just curious, do you think Tricare could justify their actions under the false claims act?
View ArticleRe: 2002 Refund Request by ins
That's hard to say because, as we have said many times, our reponses here are based just on the information that is provided to us. If additional information is received, then the response...
View ArticleRe: 2002 Refund Request by ins
That's a good question. If the provider was aware there was a payer in between Medicare and Tricare but did nothing about it then it's possible Tricare could claim a false claim was submitted. Like...
View ArticleRe: 2002 Refund Request by ins
Thanks all for responding. My research came to believe some of the pts' acct at the time of service were known to have 2nd insurances and some dont. For those pts do have 2nd listed..I know many...
View ArticleRe: 2002 Refund Request by ins
That really doesn't matter. The fact is, a claim should have been sent to the correct secondary as soon as it was known who the correct secondary was. I have never worked on a billing system that...
View ArticleRe: 2002 Refund Request by ins
I totally agreed you if there are KNOWN secondary and the biller failed to recongize it. If that were only the problem I guess....we are all in a great shape and no board such as MAB would needed....
View ArticleRe: 2002 Refund Request by ins
Okay, settle down, what I meant and failed to specifically say, is that in theory it doesn't matter, and that would be Tricare's stance. We all know in practice it seldom works that smoothly.
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