RE: [MedicalBillers] Is this insurance fraud?
- This is legal, not fraud.
pip picks up the slack once an mva plan benefits are exhausted
Date: Thu, 8 Mar 2012 17:27:21 +0000
Subject: [MedicalBillers] Is this insurance fraud?
A patient was seen for MVA, they had surgery and PIP ran out. Two of the three providers involved in the surgery are not contracted with the primary insurance. The one provider who is contracted with the primary insurance was asked to refund the MVA carrier, that money would then be distributed to the two other providers who are not contracted with the primary insurance and a PIP exhaust letter would be sent to the contracted provider to bill private health. The PIP adjuster seems fine with this, but is this considered insurance fraud? It seems a bit fishy and we've never had this request before... help!
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