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Your insurance company paid all of your claims for a surgery you have had and now they are reviewing a different claim for pre-existing condition can they go back on the claims they paid and take the?
Wiki User
∙ 13y ago
The answer may depend upon the diagnosis codes used. From your question, it sounds like the procedures had different codes and therefore, the claims should have been coded differently to reflect the different conditions.
However, insurance companies conduct random audits on their accounts on a fairly regular basis. If they find that claims previously paid were related to a pre-existing condition, they will investigate those claims and may try to recoup the prior payments.
Wiki User
∙ 13y ago
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