Did you know that failing to list co-pays collected from the patient can result in misdirected payments?
Many Alliance participating employers have implemented automatic reimbursement mechanisms with their Third Party Administrator (TPA) and Health Reimbursement Account (HRA) vendors.
In these programs, claims that are subject to co-payment are routed directly to the HRA administrator following payment by the TPA for automatic reimbursement of the co-pay.
In instances where it is not clearly noted that a co-pay has been collected from the member, the co-pay reimbursement is directed to the provider of services. This can result in patient frustration and additional work for billing staff who need to refund the overpayment.
Ensuring that billing staff are clearly relaying information regarding co-pay collected from the patient in the prior payment field of the claim form will ensure the patient receives this reimbursement directly as intended under the program.