De-Mystifying your Common Insurance Fears:
What are clawbacks and how are they handled?
Clawbacks, also known as recoupments, occur when an insurance company requests the return of money it previously paid for a claim. This is common when you’re an in-network provider and are processing in-network claims.
At Mentaya we only handle out of network reimbursement, therefore clawbacks are not applicable.
What happens if payment is accidentally sent to me?
Since Mentaya submits most claims under our NPI/EIN, if the insurance company has a policy where they do reimburse the provider instead of the client directly that payment will be sent to us instead. We'll then take care of sending payment to your clients!
Should I be worried about audits?
Audits for out of network claims are extremely rare! However, if they do happen Mentaya is here to help.
Remember: Don't hesitate to reach out to Mentaya's support team if you have any questions or concerns about clawbacks or audits. We're here to assist you throughout the process.
Related questions: What happens if payment is sent to me not my client? Will I get audited? What is a clawback?