health insurance

[labguides]

Our daughter has double health insurance coverage -- through her employee and private insurance (long story). She just received a check from hospital for overpayment of her bills (both insurance companies paid). This is a rather large check --- she wants to check with attorney to see if it is legal. But, she doesn't want to spend a fortune talking with attorney. Anyone have similar experiences after open heart surgery?

 

[bvdr]

I don't think you can keep it.

 

[Karlynn]

Sounds like this is one of those cases that no one will know something is amiss unless she reports it. Which, of course, is the honest thing to do. Darned honesty anyway.

My guess is that her secondary coverage (which ever that one is) is probably the company that's due the most money.

If I were her, I'd just return the check to the hospital and let them sort it out. If they say it's not their problem, I'd hang onto the check and see what transpires in the next few month. I wouldn't spend any of my own money on an attorney for advice. Sounds like the hospital billed both companies rather than going to the primary first and then the secondary.

 

[geebee]

What type of insurance?

What type of insurance?

If one of the insurance policies is the type of policy that pays a fixed per diem amount for hospital stays then the money would be hers to keep. However, if both policies are regular health coverage policies that pay benefits for services rendered then, unfortunately, the money would not be hers to keep. I know it will be tough to return because all the pain of surgeries make us feel as if we should be reimbursed. However, the insurance companies will figure out what happened. I am sure you do not want any issues arising from what an insurance company adjuster could call "insurance fraud". Although this did not transpire from unethical actions, trust me, there is always someone, somewhere who can twist things to make you the bad guy.