my insurance said they paid bill in error

my secondary insurance which is bcbs fep standard sent a letter to me and the provider stating they made payment in error.  they are asking the provider for a refund.  my primary insurance bcbs hmo does not cover any type of wls and we received a denial when it was sent to them.  i am freaking out...what is going on...will i have to pay this bill!  the letter states my portion of bill was corrected to $100. ..the billed amt was over 30,000...amt allowed 0 dollars...amt paid over $9000.  they are asking that the amt paid be refunded. will i be responsible for the bill if this situation does not work out?

Thanks Paul, I plan on calling them Monday.  I know they sent this letter to my Dr. I wonder what his office have to say.

Paul that is not necessarily true.   Federal Employee Programs do not  follow local and state guidelines and the insurance comissioner will not intervene in Federal Insurance policies.  They are totally handled out of Washington DC through their Office of Personnel Management. I have 30 years experience with Federal Employee Programs.   It not just as easy as normal insurance companies.  I have responded to the poster and will try to help her with the problem she is having. Vicki

Thats ok Paul. Just dont want to add more problems for our friends on this forum and stress for them I no longer work as I am medically disabled and now I am the rat or mole and willing to help anyone to fight for their lives as the insurance tried to play GOD with my life and they did with my husbands and I was still working and was afraid to stick up and say hey this isnt right and now my husband has a spinal cord injury due to the lack of insurance approving the right type of treatment. So I am truly on a vandeta to help anyone I can    I worked for 1 company 30 years in Medical Review and Customer Care and in fact I worked with many company policies and I hate insurance companies no and ashamed I was ever part of that world of crooks.   And I have my Health and Life Liscense also Federal Employee Program Ford Motor Company Ashland Oil Self Insured Fruit of the Loom Individual under 65 Policies

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If the primary does not cover WLS they are not obligated to pay anything.  As far as your secondary insurance, did they approve the surgery?  The secondary is NOT obligated to seek payment from the primary.  Working in the insurance I have seen where claims have paid in error and mistakes happen and if that is the case they have the right to seek a refund.  I have to respectfully disagree with Paul on this.  Primary denied, they have no obligation since it's an exclusion and you knew that.  I am interested to know if the secondary approved this service??

Yes the primary denied, they have exclusion on all types of WLS.  Secondary approved or pre authorized the surgery with my in-network surgeon. Could it be that they did not get the EOB from the primary and that is why they are asking for a refund or maybe some other screw up in the paper work...like the code they used.  I know my secondary insurance covers all of the WLS except maybe Lapband because others on the boards that had my surgery have gotten it covered.I had surgery at a Center of Excellance also....thought I would have no problems and now this happens.   This sucks. 

We can all speculate and give our opinions, but we do not know why they are asking for a refund, you really need to call them.  When there is 2 insurances you always have to submit the EOB from the primary, the secondary will not process claim under the prime eob is rec'd, in this case they need the denial.  However, you really need to call the secondary and see why they are asking for a refund.  Did the doctors office submit to the primary first?  Do you have the authorization letter from the secondary?

Speaking as being a past employee for the Federal Employee program liason, as FEP was your secondary carrier you would have still had to follow the same guidelines as if they were primary.  Getting the pre-authorizations and precertification as if it was primary.  Just because you had primary was another BCBS HMO, FEP follow federal guidelines and not local and state.  I am however since I am now retired medically looking into this for you also in general to see if there is any recourse and I am saying you may need to file an appeal with the Office of Personel Management in Washington.   I will get back with you and let you know exactly what you can do.