Case Study: Foster Care

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Note: It appears the provider requested payment from the patient or the insured elected to pay the services upfront to receive a discount. The provider of service is a UHI provider; therefore, a refund of $24.39 ($239.00 - $214.61) is due to the insured. The insured will need to ask the provider for the refund by going into the office with a copy of the Explanation of Benefits or mail a letter to the provider requesting a refund (include a copy of Explanation of Benefits). Per the contract, IMG cannot contact the provider on the insured’s behalf. Please see UID: 301YZ8M_006GQF2T60019XY, where Seth explained this to Ms. Walker.

The insured stated on the claim form that this service were for laboratory services, however, the charges were

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