Have you had to send money back to a dental insurance company? You may have received a letter informing you that a patient received benefits but turned out to be ineligible. Now the insurance company wants its money back. Hopefully, you sent them a check for the amount they expected to receive and then you were on your own to collect from the patient.

However, sometimes the insurance company does not send you a refund request letter. Sometimes they inform you that they will be taking this money from your next EOB. You may be keeping an eye out to see how that will happen and which patients will be affected.

Soon, you will receive the next EOB from this insurance company and start your own "Where's Waldo?" game. Starting with the first patient, you see the normal columns showing submitted fee, adjustment required, copay, insurance payment and patient portion. Everything looks normal.

Did the insurance actually pay on this claim? It sure looks like it. But wait, here's the clue: In the top right corner of your EOB beside the line for "Check number," it's blank. That's how the insurance company is telling you that no, they didn't actually pay for any of the patients listed on that EOB. Even though the columns for each patient say "Insurance paid," they didn't.

So, you've figured out that EOB, how about the next one? You start by looking at the "Check number" line and you see EFT. So, they must have paid on this one, right? Wrong. There are several patients listed on this EOB, and you can tell from the summary on the first EOB that there is still money owed back to the insurance company, but there is no way to tell from which patient they took the money.

OK, it's time to wave the white flag and call the dental insurance company. After your standard wait time, a nice representative will explain that, in fact, they didn't take it from any one patient, they just subtracted it from the total. And, she reminds you that you have to give credit to the patients even though you didn't actually receive the money.

So, what can you do? There are two options for practices who have to send money back to the dental insurance company: refund or remittance. Ask the insurance company to be set up in their system for the refund option.

Now, when this happens again, your office will receive a letter asking you to refund the money. The other option is what you are stuck dealing with now: the insurance takes money out of their next remittance (insurance payment).