Let's try once again:
The patient said to us Medicare was primary and a priv. was secondary. We billed Med. got paid, billed sec. got paid as if it was primary. Called ins. no response...phone goes from one voicemail to another.
After several visits, pt. tells us that the priv. ins. is the workers' comp. Since he has no injuries or disability (only diabetes) there was nothing I could enter as 'worker's comp' and I kept billing Medicare and priv. ins. with same results as described above.
If I don't adjust Medicare allwble, we are paid for our full charges. However if I adjust. Med. we are overpaid.
Question is :
Are we 'overpayed', and should we refund money?
To whom? Medicare or patient?
What if Medicare decides that this was a worker's comp issue and recoups all their money...if we have already paid the patient how do we get our money back?

confused.....