I was a patient with Capital Women's Care (CWC) for many years. I would have left this group a long time ago but I really liked one of the doctors. However, I can’t put up with the billing issues at this practice. I’d like all potential patients to think twice about selecting CWC.
The first issue I discovered was an over payment to CWC by my secondary insurance company. CWC filed a claim with my primary insurance company and received a full payment. Instead of billing my secondary insurance company for the leftover balance, CWC did not tell my secondary insurance company that they received a full payment from my primary insurance company. CWC was over paid by more than $1,000. It was too late when I discovered this. CWC never returned the money back to the insurance company. The second issue concerns co-pays. They routinely ask for co-pays. You may pay a co-pay that is not required. CWC collected many co-pays from me that were not necessary. Instead of giving me as credit or refund, CWC would write them off and keep them. If you realized that you overpaid and requested a refund, it would take months to get it back.
I asked the office manager why they did not refund the over payment like other practices. She rudely responded that “CWC is not like other practices, refunds will be given only by request.” So, if you don't keep track or forget about an over payment, it will disappear from your account. You may be wondering how they can get away with this. Unfortunately, there are no laws or regulations preventing providers from keeping any over payment
I tried to recover the refunds but CWC’s corporate office pointed out that they are only required by law to maintain medical and financial records for 5 years. Therefore, they can neither confirm nor deny any wrongdoing because they don't have the records. However, I have a complete file of billing statements and EOBs but CWC refuses to accept my evidence and issue a refund. It appears that this unethical billing practice was condoned from the top down.