I was going thru my tickler of EOB's that I have followed up on previously- I called A---a and wanted status on the claim that was paid out at a specialst copay and we are a pcp - well they were suppose to send back for reprocessing and so forth- so I called today and the lovely lady states that we are not the PCP on record- they had none on record from birth in aug to dec when the parents called the ins after another EOB issue- anyways this lovely
representative said that since we are not the pcp on record and they paid well over $2,000.00 in claims that they will be recouping this. I have called the parent but had to leave a msg for them- #1 question - anyway to stop the recoupment-we have called several times on the copay issue and this is the first we heard about this and if they do this #2 any advise that ya'll can think of would help me on this- I am trying to avoid a huge hassle/headache but feel that it is coming on anyways-- my mgr just said to notify the parent about what might happen (left message for mom to call me tomorrow) and take it from there- let them handle it beacuse in the end they will be responsible.
