NPR logo Letter: 'I Was The Nicest Guy In Health Care'

Letter: 'I Was The Nicest Guy In Health Care'

Andy D. writes:

Given the recent interest in the health care debate, I thought someone might be interested in a position I held: Refunds Analyst. I worked in a medical billing office for a series of radiology clinics, and my entire workday, every day, was spent looking through the billing system for accounts listed as "overpaid", and then determining why the accounts were listed as overpaid. I would then take the proper steps to remove the credit balance, either by correcting a typo, sending a refund to the insurer, or on the really good days, refunding a patient.

This could at times be an alarming position, given that it allowed me to see how many people failed to understand their Explanations of Benefits (EoBs) - including insurers and those being paid. The most common causes of overpayment were entry error, duplicate payments from one carrier, and conflicts between insurance carriers regarding which is the primary/secondary carrier.

The need for a more streamlined health care system becomes painfully apparent when even the process of returning money to a carrier is long and painful. Sometimes we might receive requests for refunds, but in many cases the carrier or patient would be completely unaware that they were owed money