PASCO COUNTY, Fla. — When you’re owed a refund, you expect to get your money back in a timely manner.
That was the expectation of a Pasco County man who said a local medical clinic over-billed him. But months later, he still hadn’t received his refund.
It all started in May 2024 when James Baxter’s wife had CT scans done at Excel Medical Imaging in New Port Richey. Baxter said insurance covered most of the cost, but on the day of testing the clinic asked for a bill upfront.
“She paid $340 upfront,” Baxter said.
Weeks later, his insurance sent the explanation of benefits, which showed the Baxter’s out-of-pocket costs could have only been around $150. At the same time, he said he received an invoice in the mail from Excel asking for an additional payment.
“I'm like, wait a minute, this is just so wrong,” Baxter said. "Something's wrong. You actually owe us money."
Baxter said he called the clinic where staff agreed he overpaid and they would mail a refund.
"I said okay, great, and she told me 60 to 90 days, and I asked why so long she said that's our company policy," Baxter said.
Baxter said 90 days went by with no check; he continued to call the clinic, but 8 months later, he still hadn’t received a refund.
"Why are you not giving us our money back? You owe it to us, just pay us,” Baxter said. "I still haven't gotten a penny back or even a reasonable explanation, so Susan, that is why I contacted you. I needed your help."
Excel’s owner, Dr. Deepak Das, claimed many parts of the medical billing system are flawed.
“Administrative over patient care, that’s the entire system,” Das said.
Das, who is also a practicing Diagnostic and Interventional Radiologist at Excel, couldn’t speak about the Baxter’s case because of privacy but said generally, between insurance and billing, refunds take a month.
“I would say in our case we're talking 4-6 months with outliers in the 7-9 month range,” Das said. “I feel for the patients."
Similar to many independently owned clinics, Excel has a third-party billing company. Das said last year, they switched companies in part because of the delays, but he also believes the entire process has too much red tape.
“The clearinghouse, the billing companies, the insurance companies, those are things that we have no control over; it's just in the wind,” Das explained, pointing out the different interests involved in determining patient refunds.
“From our standpoint, here we have this existing process that we know is so flawed and so delayed, and on top of that, in an attempt to improve our billing process, we change our billing company, and on top of that, we get two hurricanes that hit in within two weeks,” Das added.
Furthermore, Das said third-party billing companies are paid on a commission basis, so refunds affect their bottom line.
“The entire systemic process is not geared for patients' well-being; it's just not,” Das said.
After ABC Action News reached out, Excel refunded Baxter’s credit card.
“If you owe me, just give me my money back,” Baxter said. “That’s the principle of it. I don’t want to see other people affected by it like we are.”
Florida law protects insurance companies from overpayments and requires repayment within six months. However, state law does not mention when patients are overbilled.
If you’ve been over-billed and haven’t gotten a refund, Florida’s Agency for Health Care Administration can investigate those claims.
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