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Penguin Project helps Wisconsin kids with special needs
SUN PRAIRIE, Wis. (AP) — Penguins are a noteworthy bird in Sun Prairie.
They aren't a rival for the Sun Prairie Cardinals, but they do compete for the spotlight come June when penguins of all kinds take the stage at the theater. Penguins don't always get the chance to shine, so it's a welcome opportunity.
What brings them out in the warm summer weather? The Sun Prairie chapter of The Penguin Project, a Peoria, Illinois-based organization founded in 2004, which gives children with special needs the chance to perform in musical theater. It partners artists with disabilities with peer mentors, and together they put together a musical.
The Sun Prairie chapter is run through the Sun Prairie Civic Theatre.
"It's called The Penguin Project because penguins are birds that can't fly, but they can do everything else," said Sandi Klein, a volunteer with the project.
The Penguin Project was given a 2017 National Arts and Humanities Youth Program Award, which placed the group in the national spotlight and provided $10,000 to further its programming. The awards program officially closed Dec. 31, 2017, after 19 years.
The Penguin Project has been going strong in Sun Prairie for three years since program director Sara Beth Hahner brought the idea there in 2015. Support since then has been astounding — the rewards have been even more so, those involved say.
Earlier this month, dozens upon dozens of interested people came out for the annual informational meeting. So many people showed up that volunteers had to bring out more tables to accommodate everyone.
There were hugs and huge smiles all around between new faces and old.
The conversations on that chilly January day turned quickly from on stage to off stage. The Penguin Project's reach extends far beyond the final curtain for those involved.
It's an opportunity for students to "share the magic of theater" while also building a community, said Julie Rodgers, mother to two mentors.
"It is a way of opening new friendships, learning and showing empathy and just meeting other people to find out we really are all the same," Clark Rodgers told the Wisconsin State Journal .
Typically, The Penguin Project serves participants ranging from 10 to 21 years old, although that range can vary based on the individuals, Hahner said.
Though the mentors will likely not perform their artists' role during the show, each must learn the parts just in case they're called onstage as an understudy.
Mentors need to know the ins and outs of the artist's role just as well as the artist, Hahner said.
For artists who need their mentor to be on stage with them, there are ways of integrating the mentors into the scene making them more inconspicuous.
In last season's "Guys and Dolls," for example, the gamblers were getting newspapers in one of the opening scenes so mentors could hide behind newspapers if they needed to remind their artist of a line, Hahner said.
For those involved in the program, it's a long process. Rehearsals begin in mid-February for the June performances. That's nearly five months of rehearsal, which can make some interested participants skittish at first, but it's necessary for the students.
Hahner said rehearsals are gradually introduced to the artists which makes it a longer process.
"Maybe (the artists) have been in mainstream rehearsals before or have profound special needs and need assistance or they're new to being in a youth activity," she said. "We have a wide spectrum of participants so we really take it slow."
Ample rehearsal time is, however, an excellent way for the artists and mentors to bond.
Michelle Boles has been a mentor with the Sun Prairie Penguin Project since its first year. She advises anyone interested in becoming a mentor to be open to the new friendships The Penguin Project provides its participants.
Be friends with the artists, help them through the frustrating moments and get to know them, she said.
Putting in the long hours of rehearsals is well worth it once the artists hit the stage.
"Being able, at the end, to see your artist on stage having fun and doing the production and knowing all their lines and singing and dancing is really nice," Boles added. "It's nice knowing I helped them do that."
The Penguin Project can be absolutely transformative. It can take shy young people, put them on stage and give them the confidence to sing their hearts out. Klein saw that firsthand last season, her first with the project.
She said once the students really get into the production it was a beautiful thing to watch the artists evolve through the process, especially if they hadn't performed before.
One such artist is Katie Fransee, 24, who made her Penguin Project debut last season as Sister Sarah Brown in "Guys and Dolls Jr." For her it was an experience of a lifetime.
Fransee emphasized how important it is for the artists and mentors to work together to make the magic of The Penguin Project happen.
"It was a dream come true," she said.
Information from: Wisconsin State Journal, http://www.madison.com/wsj


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subset: commoncrawl


text:
Illegal Streaming of Pay TV – Is it Now a Flood?
There's an undeniable rise in the number of people illegally streaming pay TV. In recent years, there have been many reports of police actions and criminal prosecutions of pirates and the many businesses that support them. The challenge when reading and compiling such reports is quantifying the overall scope of the situation.
The global, multi-lingual, anti-piracy team at Cisco has spent decades monitoring the activities of hackers and pirates to gauge current and future threats. In recent years, we have added analytics components to quantify the scale of those threats, and the nature of the illicit streaming ecosystem worldwide. In this new series of blog posts on anti-piracy, we'll present some insights from our knowledge of this space and our recent findings regarding the crisis facing broadcasters everywhere.
Unlicensed streams of live television generally break down into two types: 'free' or 'open' networks, and 'closed' networks. The open ones are freely available to anyone who knows (or can find) the site online and generally provide a poor user-experience, supported by flashing banner adverts and the occasional unwanted malware infection.
Closed networks are far bigger operations because everyone watching has paid to do so. Whether they've bought one of the many Android boxes sold online and on high streets around the world that come with preinstalled subscriptions, or whether they've simply paid for an account and are streaming it to their existing computing devices at home, these networks give a better experience than the "free" services…. until they're raided by police in whatever country they're based and the end-users have to find another provider.
One product that bridges the two types of networks (open and closed) is the frequently discussed "Kodi Boxes". These are sometimes sold barebones, ready for people to install 'add-ons' for viewing open networks, and sometimes sold pre-configured with access to closed networks for a predefined amount of time e.g. a one-year subscription.
There are many online forums where people discuss ways to watch paid-for content without paying full-price to the rights holders and broadcasters. We typically see justifications for these practices based on cost and convenience. Also on these sites are organizations offering streaming services. These services vary greatly in size but the internet is a great equalizer – the end user is typically unaware of whether they're paying for a service run by a teenager on a home PC, or a 15-person company with racks of servers and multiple satellite installations.
Consequently, the volume of trading done by these services ranges enormously too. For example:
- One operation had "tens of thousands" of customers: In August 2016, a raid in the UK of a streaming operation resulted in the seizure of approximately 30 servers and 15 satellite dishes providing content from many broadcasters worldwide. The head of the UK's Police Intellectual Property Unit described the outfit as "a significant and highly resourced operation to distribute pirated television on an industrial scale to tens of thousands of people across the globe." (Source)
- One operation had 70,000 customers: According to court papers during the investigation into a network in Malmö, Sweden in September 2016, there were 70,000 customers of this service.
- Another had 100,000 customers: In December 2011, the "Australian arm" of a global piracy group was raided on intelligence generated by a private investigator hired by a Chinese broadcaster. Police estimated that the shop "L&D LED Signs" was "part of a global piracy operation worth A$150 million a year and with 100,000 customers" (Source)
- A very large organization claims 170,000 subscribers: On the site of RAPIDIPTV they openly boast of having 170,000 subscribers. Even if it's an inflated number, it's an indicator of the potential size of this group.
Cisco's anti-piracy team is highly active wherever piracy is discussed and conducted. From our experience, we know that those are examples of large players in this industry.
To get a greater understanding of the bigger picture, it's worth analyzing one of the main places where live streaming servers are advertised: forums. Our investigations have shown that:
- Servers which have only been recently launched can be expected to have hundreds of subscribers
- Well-established servers might have 5,000-10,000 subscribers
- The most significant players (as shown above) might have tens of thousands of subscribers
We sampled one of the most active online forums for streaming services and saw 285 servers advertised. It's not unusual to see them promoting their services openly like this for many years:
Conservatively, it's fair to assess that for these 285 servers, there's an average of 1,000 viewers per server in this highly competitive environment. When we extrapolate from the forum described above, we can conclude that this single forum can easily reach 285,000 viewers. An average forum has offerings of hundreds of servers and each one has thousands of customers. So, with hundreds of popular forums worldwide and thousands of customers per site, the global scale of the problem is clearly visible to those of us visiting the forums and maintaining statistics.
This series of blog posts will continue to highlight the findings of our ongoing research.
What do you think about the rise in illegal streaming of Pay TV? If you feel strongly about any of the topics raised in this piece (or ones we've left out!), use the comment box below to share your thoughts with us.
For more on our piracy intelligence research findings, please see these related blog posts:
- Same Pirates, New Means: From Card Sharing to Content Sharing
- Crack-down on video streaming-piracy on the rise
- A Few Words on Streaming Piracy Operations… and the Limitations of Current Anti-Piracy Measures
In an effort to keep conversations fresh, Cisco Blogs closes comments after 60 days. Please visit the Cisco Blogs hub page for the latest content.
4 Comments
The use of Kodi in this context is disingenuous. Kodi is not, never has been, and never will be, a piracy platform. This type of report perpetuates this misconception of Kodi and does a disservice to the folks who invest a ton of time and energy developing this platform. Kodi is misused to provide pirated content in the same way that Firefox and Chrome are misused to access pirated content. Please stop lumping the Kodi project in with those who deliberately violate the law.
Melvyn Mildiner
The only reference to Kodi in this blog post is in the context of the label often used on sites such as Amazon, eBay, AliExpress when selling Android TV boxes. These are undeniably sold most commonly as "Kodi boxes".
Of course, Kodi is only one player out of many that can be used for piracy.
And yes, the basic installation of Kodi as distributed by the XBMC Foundation is not focused on piracy.
But I think it's actually disingenuous to pretend that's all Kodi is known for. Even the foundation's president knows it has a reputation problem thanks to the add-on community that has helped Kodi become synonymous with piracy around the world.
As reported by the British newspaper 'The Express' (http://www.express.co.uk/life-style/science-technology/792491/Kodi-Block-Download-Add-On), Federation Against Copyright Theft (FACT) have branded the use of Kodi software to access pirated streams as "an epidemic". They singled out Kodi not because it's a piracy platform but because it's the most widely used in this context.
I wish Kodi every success in distancing themselves from piracy (apparently they're even considering implementing DRM to entice legal content providers to the platform http://www.kitguru.net/channel/generaltech/matthew-wilson/kodi-wants-to-attract-more-legal-content-may-implement-drm-to-help/) but for now they are, even if it's unintended and undesired, inextricably linked with piracy in the minds of the majority of its users.
My ignorance or lack of coffee has me this morning. Pay TV and live TV are the same thing? Not sure what live streams are illegal, or even why. Is this OTA broadcasts? Where can I find more information on this?
Melvyn Mildiner
The terminology here can be a little blurry here, but since I've just finished my first coffee I'm in a position to clarify 🙂
Since there are many free-to-air channels in the world, "Pay TV" and "Live TV" are not the same thing.
When we refer to "pay tv" we're describing the television channels which are sold by broadcasters to paying subscribers. When it's streamed on the internet for free, or for a charge to a third party who is sharing that content without permission from the rights holders and broadcasters, that is often a breach of national laws (copyright and others). In addition, it almost always breaks the contract to which the original paying subscriber has committed. In cases when it's only the contract that's broken (and no laws) it's unauthorized rather than illegal, but the end result is the same: someone is sharing content for which they have no rights to people who aren't paying the original providers.


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NDP should control government costs instead of dental bills
Spending time in a dentist's chair, necessary as it is, is unlikely to replace the beach as a favourite summertime activity. Whether it's cleaning the pearly whites, or enduring cavity repairs and root canals, caring for one's teeth has a certain eat-your-broccoli sense of duty about it.
But dentistry experiences aside, the provincial government's latest command-and-control intervention in prices - the province wants dentists to cut their fees by more than the Alberta Dental Association and College's recommended three per cent - is evidence of power-tripping and hypocrisy.
When the college released its new fee guide, Health Minister Sarah Hoffman signalled her government's discontent: "Obviously there will be a bit of a negotiation ... they got the message loud and clear that three per cent just isn't enough."
The guide recommends, but does not mandate, prices for dentists.
Being self-employed, I pay my own dental bills. From repairing a cracked tooth to regular checkups, I write the cheques. I have everything to gain from a more dramatic cut to dental fees.
But I prefer that the soft Alberta economy, competition between dentists for patients and insurance industry pressure spur dental bill declines, not government politicking accompanied by veiled threats.
The last thing Canadians need is yet another sector where input costs and entrepreneurial risk-taking count for less than political machinations.
Interference in price signals doesn't help clarify the actual cost or demand for any service or good; such interference instead pollutes the possibility for clarity.
The reason that matters is illustrated by a conversation I once had with Dr. Brian Day, owner and founder of Vancouver's Cambie Surgery Centre.
Day has long battled with politicians who protect the ineffective status quo, government-insured, government-delivered health care approach, as opposed to thinking about how to provide universal health care but through a variety of providers and insurers: private, government and non-profit alike.
I recall Day because a Vancouver hospital once asked him to help design pricing for out-of-country patients.
The hospital, properly, did not want to accidentally subsidize a foreign patient by undercharging.
To ensure that didn't happen, the hospital first had to figure out what their input costs were, for example, for a trekking tourist who might have broken a leg.
Day was happy to help, but the request illustrated how government-run services are provided: with little knowledge of input costs and no incentive to grasp such measures. That's because Canadian hospitals are mostly run on budgets handed down from governments.
Even if hospital administrators desire efficiencies and effectiveness, which they do, there is little natural pressure to provoke reforms to that end. (If their budgets came from a variety of government, private and non-profit payments, healthcare delivery would quickly reform to be more patient-friendly.)
Which brings us back to dentists: Political pressure on a dentist's association runs the usual risk of government-mandated prices, irrespective of costs.
That's a recipe for lousier service and fewer options. It's already evident in the mostly government-run primary health care sector in Canada. It is why we have waiting times for medically necessary treatment.
There is another reason provincial politicians should avoid lecturing dentists, or anyone else in the private sector about costs: Because the NDP, since coming to power in 2015, has done nothing to reduce its own burden on taxpayers - public sector wages and pensions that exceed similar positions in the private sector, as an example.
Or more broadly, since coming to power in 2015, the new provincial government has consistently raised input costs for the private sector: From the carbon tax to its plan to hike the minimum wage by nearly 50 per cent over four years ($15.00 in 2018 compared with $10.20 in 2014), the province has not practised what it now preaches to dentists: rein in costs. Mark Milke is a Calgary author and columnist.
Originally published in the Calgary Herald, September 2, 2017, A10


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Advances in OptoElectronics
Volume 2008, Article ID 752847, 6 pages
Phase Velocity Estimation of a Microstrip Line in a Stoichiometric Periodically Domain-Inverted Modulator Using Electro-Optic Sampling Technique
Division of Advanced Electronics and Optical Science, Graduate School of Engineering Science, Osaka University, Toyonaka, Osaka 560-8531, Japan
Received 30 April 2008; Accepted 30 July 2008
Academic Editor: Chang-qing Xu
Copyright © 2009 Shintaro Hisatake et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
We estimate the phase velocity of a modulation microwave in a quasi-velocity-matched (QVM) electro-optic (EO) phase modulator (QVM-EOM) using EO sampling which is accurate and the most reliable technique for measuring voltage waveforms at an electrode. The substrate of the measured QVM-EOM is a stoichiometric periodically domain-inverted crystal. The electric field of a standing wave in a resonant microstrip line (width: 0.5 mm, height: 0.5 mm) is measured by employing a CdTe crystal as an EO sensor. The wavelength of the traveling microwave at 16.0801 GHz is determined as 3.33 mm by fitting the theoretical curve to the measured electric field distribution. The phase velocity is estimated as m/s, though there exists about 5% systematic error due to the perturbation by the EO sensor. Relative dielectric constant of is led as the maximum likelihood value that derives the estimated phase velocity.
1. Introduction
Wide expansion of an optical spectrum by a deep phase modulation at a high-modulation frequency is the essential technique for many electro-optic (EO) light controlling fields, such as ultrashort pulse generation [1], comb generation [2], time-to-space mapping of an optical signal [3], and so on.
Quasi-velocity-matching (QVM) with periodic domain inversion of an LiTaO3 (LT) or LiNbO3 (LN) crystal in a traveling-wave EOM is one of the promising techniques to widely spread the optical spectrum. Especially, periodically domain-inverted stoichiometric LT (SLT) crystals are attractive QVM-EOMs because of their stronger EO effect and lower coercive fields than congruent-melt LT crystals. On the basis of the QVM technique, Morimoto et al. spread a 3-THz-wide modulation sidebands (comb) at a 16.25-GHz modulation frequency [4]. The QVM technique compensates for velocity mismatching between an optical group velocity and a microwave phase velocity in the EO crystal by periodically inverting the sign of the EO coefficient of the crystal. In the ideal QVM-EOM, the modulation index is almost proportional to the interaction length and as a result, large modulation index at the high modulation frequency can be achieved with long device.
Accurate values of and are needed in designing the QVM-EOM, because uncertainty of these values results in degradation of the modulation efficiency, which is achievable modulation index per unit interaction length per unit modulation electric field strength. The group velocity of the optical wave can be calculated with group refractive index of the EO crystal. Likewise, the phase velocity of the modulation microwave is calculated as , where is the effective relative dielectric constant which is determined by the geometry of the transmission line and the relative dielectric constant of the substrate. The group refractive index of SLT crystals is estimated accurately using Sellmeier equation with constants listed in [5]. In contrast with the accurate value of , very little data of for LT crystal are available, which is in the range at microwave frequencies [6, 7]. To our knowledge, no accurate data of for SLT crystals at microwave frequencies are available.
In this paper, we estimate the phase velocity of the modulation microwave in SLT-based QVM-EOM on the basis of a direct observation of an amplitude of a standing-wave in a resonant microstrip line using EO sampling technique [8]. Because the EO sampling is accurate and most reliable technique for measuring voltage waveforms at an electrode, the phase velocity can be estimated accurately from the relation of , where is the wavelength of the traveling microwave and is the resonant frequency. In Section 2, the principle of the QVM is summarized. Section 3 discusses influence that the estimation error of the phase velocity gives to the modulation efficiency. In Section 4, experimental results are presented.
2. Quasi-Velocity-Matching
Figures 1(a) and 1(b) show a schematic of a normal traveling-wave EOM and a QVM-EOM, respectively. To avoid unnecessary complexities, we employ a one-dimensional analysis for our devices. For a traveling-wave EOM, if the axis is the direction in which the optical and modulation wave propagate in a virgin (single-domain) EO crystal, the variation of the refractive index induced by an electric field is obtained at aswhere is the amplitude of index changes, is the extraordinary refractive index of the crystal, is the EO coefficient of the crystal, and . A half-period of the domain inversion is given by where is the phase velocity of the modulation wave, and is the group velocity of the optical wave. Here, we assume that the optical wave arrives at point at time .
For , the phase retardation of optical wave at the position is expressed aswhereIf there is the so-called velocity mismatching between the modulation wave and the optical wave, the modulation index becomes a periodical function of with period .
When a traveling-wave EOM has a suitable domain-inverted half-period of , QVM occurs and accordingly a large modulation index is achieved. In such a situation, phase retardation given to the optical wave passing through the length of , , in a periodically domain-inverted crystal as shown in Figure 1(b) is expressed as
The modulation index can be expressed by
Figure 2 shows modulation indices of (a) the QVM-EOM, and (b) the typical traveling-wave EOM (velocity mismatching). The solid line of Figure 2(a) is calculated using (6). The modulation index achieved by QVM-EOM is almost proportional to the interaction length though it is lower than perfect velocity-matched condition by a factor of 2/. The upper limit of the modulation index for non-domain-inverted EOM is .
3. Efficiency Analysis for the QVM-EOM
The analysis presented in the former section was ideal case in which there is no error in the period of the domain inversion. Uncertainties in the value of the phase velocity and group velocity degrade the modulation efficiency through the length error of the domain-inversion period for the QVM. In this section, we will discuss degradation of the modulation efficiency in the presence of length error in the period of the domain inversion.
Figure 3 show the refractive index changes seen from the optical wave in periodically domain-inverted EO crystal. The half period of the domain inversion in Figures 3(a) and 3(b) is and , where , respectively. The QVM occurs in the case of Figure 3(a), and as a result the traveling optical wave of sees the positive refractive index change throughout the interaction. The case of 10% error in the domain-inversion length is shown in Figure 3(b). If there is an error in length of domain inversion, the optical wave of sees not only positive but also a negative refractive index change throughout the interaction.
Figure 4(a) shows the normalized modulation index calculated for the interaction length of . The modulation efficiency almost proportionally decreases with the increase of . The modulation efficiency decreases to about 50% in the case of . Figure 4(b) shows the modulation index as a function of the interaction length. The calculation is carried out for the length error in the half period of the domain inversion of (i) , (ii) , and (iii) . An upper limit of the modulation index exists if . Because longer interaction length is essential for larger modulation index, it is important to estimate the length of the half period of the domain inversion in high accuracy.
Propagation of uncertainties of and can be evaluated by
The influence on the modulation efficiency of uncertainty of is lower than half of the influence on the modulation efficiency of uncertainty of . Moreover, can be estimated more accurately than by using Sellmeier equation with constants for SLT crystal listed in [5]. Using Sellmeier equation, at nm is derived. From this reliable value of , the group velocity is derived as m/s.
The phase velocity of the modulation microwave can be calculated as . The effective relative dielectric constant for microstrip line can be calculated using Kobayashi's formula [9, 10]. Kobayashi's formula is claimed to predict dispersion better than 0.6% in the range and , where and are width and height of the microstrip line, respectively. However, uncertainty of the estimated is comparatively large, because the reported value of for LT crystal is inaccurate and ranging [7]. If we employ values of of the modulation microwave for 16.25 GHz can be calculated as m/s m/s using Kobayashi's formula. In that case, the half period of the domain inversion for QVM at 16.25 GHz is calculated as 2.7 mm 3.1 mm with the group velocity of m/s. There is 14% of length uncertainty in the half period of the domain inversion. From Figure 4(b), results in the degradation of the modulation efficiency to about 10%.
4. Estimation of the Phase Velocity of the Modulation Wave Using EO Sampling Technique
Figure 5 shows a schematic of our QVM-EOM. An SLT crystal is used for an EO substrate. The modulation electrode structure is a microstrip line. The width of the microstrip line is mm and the height of the substrate is mm. The strip line is open-terminated for resonance.
Figure 6(a) shows an experimental setup. A pulsed fiber laser (repetition frequency: MHz) was used for probe pulses. The repetition frequency of the pulsed laser and the frequency of the microwave signal source are synchronized with each other. The frequency of the microwave should be set to be , where is an integer and is an offset frequency. In the experiment, the frequency of the microwave is set to be GHz, where and kHz.
Figure 6(b) shows a cross-section of the microstrip line under the measurement. A CdTe crystal is used for the EO sensor. The aperture size of the EO sensor is 3 mm 3 mm. The probe beam is focused on the CdTe crystal by the object lens (). The spot size is about 20m. The probe beam is reflected by a dielectric mirror attached to the EO sensor. Polarization of the reflected beam is modulated by the electric field of the microwave. The polarization-modulated beam propagates along the same path of the incident beam path. Two orthogonal polarization components of the modulated beam are differentially detected by two photodiodes. The detected signal component of passes through a bandpass filter whose center frequency is 100 kHz. The amplitude of the signal, which is proportional to the amplitude of the electric field of the standing wave, is measured by a spectrum analyzer.
In the experiment, we scanned the probe beam in the -direction with 50m step and measured electric field profile of the resonant standing wave. Figure 7 shows an experimental result. The theoretical curve of (solid line) is fitted to the experimental data. Fitting parameters are offset power and . From the least square fitting, , and are estimated as dBm, , and , respectively. As a result, the wavelength of the traveling microwave is estimated as mm. The phase velocity at the modulation frequency of GHz is estimated as m/s. From this phase velocity, relative dielectric constant of is derived using Kobayashi's formula. The half period of the domain inversion at the modulation frequency of near 16 GHz is derived as mm with the phase velocity of m/s and the group velocity of 1.24 m/s.
The estimated phase velocity is slower than the real-phase velocity because of the perturbation of the EO sensor. In our case, this systematic error is estimated by numerical analysis (moment method) to be 5% or less. The 5% error in the phase velocity corresponds to the domain-inversion length error of which results in the degradation of the modulation efficiency to about 50%.
The systematic error depends mainly on (1) the difference of the dielectric constant between the device under test (DUT) and the EO sensor, (2) the distance between the DUT and the EO sensor, and (3) the thickness of the EO sensor. Using low-dielectric constant materials such as a polymer [11] as a sensor, the perturbation can be reduced. By loading a low-dielectric material between the DUT and the sensor to keep a distance, the perturbation can also be reduced, though the sensitivity is reduced at the same time. The use of a thinner sensor is an adequate plan to reduce the perturbation, however it also reduces the sensitivity. For a specific case, the tradeoff relationship between the perturbation strength and the sensitivity has been analyzed in the literature [12].
By using SLT substrate of the EOM as the EO sensor, it is also possible to measure the standing wave without using an external superstrate sensor [13]. In this case, special geometry should be constructed to transmit the probe beam between the microstrip line and the ground plane. This type of EOS system is now under construction and the results including the comparison with current technique will appear elsewhere.
5. Conclusion
We have estimated the phase velocity of the modulation microwave of 16 GHz in the periodically domain-inverted SLT phase modulator. The theoretical curve of the amplitude distribution of the standing wave in the microstrip line was fitted to the experimental data measured by EO sampling technique. From the curve fitting, the phase velocity of m/s was estimated though there is about 5% systematic error due to the perturbation by the EO sensor. Relative dielectric constant of was led as the maximum likelihood value that derives the estimated phase velocity.
The authors would like to thank Drs. H. Togo and N. Kukutsu from NTT Microsystem Integration Laboratories for their cooperation and support. They also thank Dr. T. Kobayashi for helpful discussions. This research was partially supported by a grant from the Global COE Program, "Center for Electronic Devices Innovation," from the Ministry of Education, Culture, Sports, Science, and Technology of Japan, and Grant-in-Aid for Scientific Research on Priority Areas, 19023006, 2008.
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Regulations on Refunds
In recent years the regulations have clamped down hard on refunds. That's why you are seeing us get these "Requests for Refunds" to you monthly. In the "old days" we used to hang on to the smaller refunds and just flag the accounts for the patient's next visit, or hold insurance overpayments waiting for the insurance company to request. But no more. The rules as they relate to compliance now require all refunds (regardless of size) be refunded within 60 days. Insurance companies. Medicare and Medi-Caid are the most stringent. We must proactively report overpayments or risk heavy fines and penalties.
Here's a good summary pertinent information on the regulations:
- The OIG published a list of risk factors the OIG identifies as "particularly problematic." Bullet five on this list is "Inadequate Resolution of Overpayments," otherwise known in the billing industry as resolution of credit balances. In essence, it says that providers may not keep payments that do not belong to them.
- Very few, if any, billing companies relish the prospect of resolving credit balances. Much time and effort is devoted to collecting information, creating charges, submitting claims, and collecting payments. To have to spend additional time and energy trying to return this money seems like an untenable situation. And yet the government is very clear in its guidance: "Billing companies should institute procedures to provide for timely and accurate reporting to both the provider and the health care program of overpayments."
- Processing and returning credit balances, or "overpayments" as the government calls them, is not optional but mandatory. The term "credit balance" can be defined in a number of ways; however, we will define it as "improper or excess payment made to a practice/provider as a result of patient billing or claims processing errors."
- It's not uncommon for providers to keep such overpayments until specifically asked to return them or until payers have withheld them from subsequent payments. This is illegal.
- The rule also addresses the timeliness of refunds and requires Medicare providers to report and return an overpayment to the appropriate patient, intermediary or carrier within 60 days of identifying the overpayment.
- A frequently asked question is, "Must a provider refund all monies?" The answer is yes, for both patients and federal payers, i.e., Medicare and Medicaid. For commercial payers, a provider may set a refund threshold—for example, only credit balances of $10.00 or more shall be refunded—remembering the threshold must be a reasonable amount
In addition to the regulations, prompt refunds are a good business practice. By keeping up with refunds monthly your A/Rs are clean, they more accurately represent your totals, no large months of refunds so cash flow is more stable, and you have happy patients!
177 Responses to "Regulations on Refunds"
What if a commercial insurer (non-contracted) erroneously pays a claim but it is not an overpayment (no credit balance exists). Does the provider have to return the payment?
The answer as I understand it is "No". If the provider did nothing to misrepresent the claim and if the error is exclusively the insurance company's error, and no overpayment exists…then the insurance should seek refund from the patient!
I would say if you know it was paid erroneously you should refund it and state the reason why. This was the practice at the last company I worked for. I'd say it's ethical. Maybe it would depend on the reason it was paid erroneously.
Is there a Kansas Law that providers/facilities do not have to refund payer if the payer has not asked for the money to be returned? And if the refund is over a year old the provider/facility can keep the money?
Regulations on Refunds:
We are getting multiple requests from non-contracted insurance companies stating that the patient policy actually terminated back in 2016 and they are looking for us to recoup the amount they paid. We are also received requests them stating the patient only has so many drug screens per year and they over paid the number and want the money returned. Is this correct? and if not, where is it written that we could use this information in a letter to them?
Hi Trish,
I work in Colorado and our State Statutes list in writing that commercial insurances doing business in the state of Colorado must resolve all claim issues within 12 months from the date of service. Once this time has past neither the provider or the insurance company may seek restitution and any outstanding charges may not be balanced billed to the patient. In other words after 12 months its a write off for everyone. Check your State Statutes!
What about escheats requirement for those balance which aren't refunded? Aren't you required to escheat down to the penny ($.01) if you aren't refunding?
I work for a doctor as the office manager. It's a small office with just the doctor and myself. I occasionally bring it to the doctor's attention when a patient has overpaid on their account. Unless the patient asks for it, he tells me to "let it go". I am uncomfortable doing this, but I don't know how to address my concern with him as it's not my business. Would I bear any responsibility in this if it came to light? Any suggestions on how to deal with this without losing my job?
"The answer is yes, for both patients and federal payers, i.e., Medicare and Medicaid. For commercial payers, a provider may set a refund threshold—for example, only credit balances of $10.00 or more shall be refunded—remembering the threshold must be a reasonable amount"
For federal payers, it seems there is obvious legislation (ACA etc.) requiring repayment for repaying credit balances – even a penny over.
However, where do you find support for paying back patients and commercial payer thresholds?
For example, I am in Colorado, and the unclaimed property (escheat laws) make it appear that you have to report credit balances after a year anyways. Even if you set a $10 threshold, when you report to the state for unclaimed property, you would have to show that you attempted to return the money.
I guess my question is, what is the basis for your statement that you have to pay back patients, but that you can have a threshold for commercial payers? Is there any statutory support for a state like Colorado? I haven't found anything except that unclaimed property laws require you to attempt a return when you report to the state after a year.
Some states like Texas have explicit patient over-payment and physician refund laws, but others don't seem to have that (like Colorado).
Hopefully that all makes sense!
I am a patient and overpaid by $41 for an appointment in July, 2017 because the doctor's office overestimated what I would owe. They are telling me that they do not issue refunds and will apply a credit to my next appointment. I told her I would meet my full deductible (I am on a high deductible plan) before the next appointment in April, 2018 and that I would like a refund. She e-mailed back and said it is their policy to hold the money until after the next appointment. I am likely not going back to them again and want them to issue the refund. Should I send them this article?
I am wondering where to find my State/Local laws in regards to this. I work/live in Michigan. What "wording" or websites should I be looking into to get the local answers. I am not able to find my "local" laws just common answers to this. I work for a doctors office that has multiple accounts in which we owe patients money. I am VERY uncomfortable about this and want to find the Michigan laws to show the doctor that we need to give refunds. Please help. Thank you
I was able to locate information by searching under " (enter state) patient over-payment and physician refund laws". That should help
If I work for a doctor who over $50,000 dollars in patient credits and she refuses to pay patients back. Is there some where she can be reported. Do we as employees have a responsibility to report this? It feels like they are stealing from patients by not returning them. The employees are not allowed to tell patients they have credits. The office counts on people not looking at there EOBs or understanding the system.
We inform an insurance company of an overpayment. If an insurance company ALWAYS recoups its overpayments in future payments to us, does the 60 day deadline apply? 80% of our insurance companies recoup from future payments.
Is the 60 days for refunding a payment period? Or is this just if you are a contracted with the carrier? I have multiple fund request for non contracted carriers and am wonder if the time frame for issuing payment is longer?
I have researched the regulations for the Washington State regarding "insurance" refunds however I cannot find information in regards to handling refunds that are either rejected or returned by the payer to the provider. At one time, some states allowed the provider to keep an overpayment when they had already in fact submitted a refund to the payer but the payer either, reissues the payment or returns the refund. Is this still the case or what would be the suggested/proper way to handle this. I am specifically referencing provider payments and not patient payments. I understand that patient payments would be reported as unclaimed property when appropriate refund attempts fail.
My account has been overpaid in excess of $1,000 since June 2017 and I cannot get a refund – how do I file a complaint and cause this facility to pay a penalty.
Is there a particular regulation to how the refund should be issued. For example: if payment was made by credit card, can the refund be in a check form or should it go back to the credit card?
I would like to receive clarifiation on the following scenario. If a provider receives an overpayment from insurances such as Mutual Omaha, Coventry, or any self-paid insurance and said insurance makes a payment causing a credit where should the payment be refunded to. The patient because they paid their premium or back to the insurance that made the payment? Please advise I am not able to find a direct response that regulates why the patient would get the refund rather than the insurance. Thank you in advance.
I just went to a ENT specialist and filed an e-claim. My insurance provider and even CPF dept work really efficient. Only 3 weeks time I had received the letter said that my claim is successful. The problem is here, I had make full payment to the clinic but my claim instead pay to me is pay to the clinic. I will need to wait for the clinic to reimburse back the payment to me. May I know what is the maximum time frame the clinic must make the refund to me? As the clinic account department had told me very rudely that they are very busy and claim is only can refund to me within 6-8 weeks.
I am a billing mgr for a private ambulance company in California. We recently received notice from a commercial insurance company that they had audited their payment records and determined that for a period of 1/1/2015-3/31/2017, we overbilled them $980,000 and they want their money back. During that time frame, we were not contracted with this insurance company. We billed them at the rate our county EMS agency either mandated or suggested as a rate. The overpayment was due errors being made in how the ambulance transport was coded. My question is, is there a statue of limitations that pertains to an insurance company demanding payment for having over paid a claim?
Do you have to have contracts with insurance companies if you start a Business to Process Refunds for Medical Insurance Companies from Physician offices or the Hospital?
I have a patient who has Cigna insurance company. I have been fighting for almost 2 years to get paid from Cigna on services from our office. About 4 to 6 months ago, we finally got paid. We just received a letter from Cigna's collection agency stating that they want all their money back because it should have gone to the patients deductible.. Our clinic has done nothing wrong and all claims are legitimate. Since this is the insurance companies fault for paying us in the first place and not charging the patient, do we absolutely have to pay Cigna back for Cigna's obvious error. We are in the state of Illinois. Thank you
I have a question regarding medical bills. I contacted the billing department; however, they are giving me excuses of why they cannot refund my overcharge payment. What can I do to proceed? Thank you.
What are the regulations for refunds of overpayment of premiums when Medicare is involved?
I have a question regarding over-payment from commercial insurance companies. I recently took over the billing manager position for a small clinic. Reviewing accounts we have come across a few credit balances that should have been returned to the insurance company, however the claims are from 2011-2016. Are we still obligated to refund the insurance company?
I have been unable to find an answer regarding a question I have. I have a few credits on accounts and am having trouble with refunding. The patient has an employee supplement that I would assume was earned through retirement benefits and then they also have a self purchased supplemental policy. Neither policy will coordinate benefits with the other and will only pay as a secondary to Medicare. In this situation is it correct to refund the patient any credit amount paid by the self purchased policy?
My insurance company had paid me back some money from when i was going to see a chiropractor and it was supposed to be money that they paid after i met my deductible. Now 5 months later they are wanting that check back. I was wondering if this is legal for them to do?
I had to pay a provider to have a procedure done, back in November 2017. I paid using a credit card. The claim was processed a few weeks later and I had been overcharged by approximately $600. When calling the provider to receive a refund on my overpayment, they said they couldn't issue refund because the claim is not accurate. Since then, I've been back and forth with the Insurance company and the provider, even having 3 way calls. They both insist the other party is wrong. The provider says the claim is not paid according to the contract, and that I should have even more money coming back than the initial claim indicated. However, the provider will not refund me any of my money. The insurance company said they have processed the claim correctly, and it will not be reprocessed again. What can I do to get my money back?
I switched insurance companies so was self-pay for a follow-up visit to a specialist for whom I was no longer covered. The office required me to pay $250 just to make the appointment and told me they'd bill me more or issue a refund after the appointment. Three weeks after the appointment, I called and was told I had a $68 credit. I asked why it hadn't been refunded and they said their policy is not to issue refunds unless patients request them. I requested that they immediately refund the balance on the credit card with which I had paid (in advance). They said all refunds needed to be reviewed which would take 14 business days at which point, if approved, I would be mailed a check. Is this policy legal?
An insurance company quoted the doctors office a certain amount for the deductible. But by the time the procedure was done and the claim filed the deductible amount had changed. The patient had borrowed the money from her church for the deductible which is now a credit and the church paid the doctors office directly with a church check. Who does the doctors office refund?
Thank you
How would I properly handle account credits that have been sitting on patient's accounts for years? I want to be compliant with this but it seems that it has been something that has been overlooked in the past, now I have hundreds of accounts with credits on them, dating back several years.
Our Specialist does not contract with ll ins. payers, and patients are informed when their insurance is not accepted at our office. Many say "then I will pay cash" – they pay for the initial visit and afterwards send their insurance information to our billing company insisting that they bill the insurance "because they had been told that the insurance would pay" Many of the insurances have a provision to pay for not-in-network MDs, but the reimbursement is a token payment (once we received a check for $1.20!) The the pts. ask for a refund of all the money they pay because "we need to accept the insurance payment as payment in full" and they demand a full refund of the payment they made on the first visit. It seems that this is a well known strategy and we are seeing more and more patients doing this. How can we protect our business besides denying services to these patients? There are some that do not even disclose they have insurance and then send ins information to the Billing office. Can we issue a letter at the first visit stating that if they decide to be self pay, the funds will not re refunded when they submit ins, retroactively? thanks!
I would like to know if we owe interest to a patient on overpaid co-pay?
Also if we make refund to CC can we legally charge patient the processing fee if the refund was patient's mistake?
If a retroactive denial (causing refund request/ recoupment warning) is due to an error on the insurance company's part, do we have any ground to refuse and request they collect from the member instead of the provider. Our staff verified eligibility (we have confirmation on file) and it identified the patient as insured. Now, several months later they now show no active policy on the DOS and will recoup out of future payments if we do not refund in 30 days. It just doesn't seem like it should fall on the provider to reimburse another individuals mistake. Perhaps it wouldn't be as big of an issue if it didn't happen so often with this particular company.
I work diligently to maintian compliance in all areas and I realize they are entitled to their money back. I'm just curious if there is a way to force the insurer/insured to settle the dispute, rather than our provider suffer the financial burden. Thanks for your advice/opinion.
I'm currently handling patient accounts that require a refund to several different health insurance companies, i.e. BCBS and United Healthcare. The insurance companies stated they could not accept the refund due to the account being several years old and that the claims were purged from their system. Also, it does not appear that the patient made a payment towards the account. At this point should I refund the patient or their next of kin since I couldn't return the money to the health insurance company?
I do billing for a dental practice, and we are receiving refund requests from a commercial insurance that originally paid us as out of network, but are now back dating the provider (without our knowledge) to the date he started working for the practice and is requesting the difference back as a refund. My question is, are we able to impose a processing fee for all of the refunds we are having to process (over 100)? They want individual checks for each claim.
Is there a way to report a billing office for taking over 60 days to process your refund? I have been fighting with a doctors office since February and they still have not paid me even after multiple requests.
When I got pregnant, my OB GYN told me I needed to make payments each visit, to apply toward the cost of my labor and delivery (my understanding was this was because my BCBS plan wasn't that great), but I ALSO had medicaid and didn't know any better to question it, so I just made the $200+ payment per visit until I was paid in full before my cut off period. Fast forward to April 2017, the hospital bills Medicare and BCBS for my labor and delivery and I have $0.00 balance with the hospital. In June 2017, my OB GYN office sends a check to the hospital for $2,150 from my pre-payments – but I have no balance to apply it to. So the hospital is telling me that this payment for my labor and delivery pre-payment was applied to some account from an ER visit in 2012 that had previously been sent to collections – but I had NO clue about – its not on my credit report, I have no statements from it.. they are just verbally telling me theres a balance it was applied to.
So my question is – should I be due a refund for the overpayment since it was made towards a different bill (and really shouldn't have been paying in the first place if the Dr's office would have properly instructed me on have the dual insurances and the fact that I didn't need to prepay when having Medicaid). Or, is this a lost cause because it was applied to another account? so my Labor and delivery account really does not show a credit, since they moved it to another account?
I have Medicare, a Medicare supplement policy with Mutual of Omaha, and a full Blue Cross Blue Shield policy that is a state employee retirement benefit. Omaha has no coordination of benefits provision. Both Blue Cross and Omaha pay the amount not covered by Medicare, creating an overpayment situation. Some of my providers automatically refund overpayments to me. At least one provider (out of state) has returned the overpayments to BCBS who sent them back to the provider because they—BCBS—were contractually obligated to make those payments. I contend that all of the overpayments legally belong to me. Is this a correct contention? If it is, where can I find written verification of it? Do you know of state statutes or case law that addresses this issue? I live in North Carolina. Thank you this website!
My daughter and son-in-law paid a $6,100 deductible to a hospital in Los Angeles for my granddaughter's surgery last November. This was at the beginning of her cancer treatment, and the deductible had not been met previously, so they paid what the hospital said they owed. The hospital dragged its feet on submitting the claim to my daughter's insurance (OSCAR) and then erroneously coded it (hospital admitted that it did not include the correct DRG code). After months of going around and around with OSCAR and the hospital, we filed a complaint with the Dept of Managed Health Care, who promptly intervened and told us that an adjusted claim had been submitted and the claim would be processed within 30 days, and there was no patient responsibility (meaning my daughter does not owe anything on that particular bill) after insurance pays. Many other claims were processed during this time period such that the deductible and all co-pays/co-insurances were met, so the $6,100 payment made to the hospital in November is an overpayment. Last Friday, I spoke with the hospital who informed me that they received a $13,000 payment, but were still owed $17,000 by OSCAR and no refund could be issued to my daughter because their policy states that refunds are only issued when the credit balance appears. The hospital said it has disputed the OSCAR payment, but until the $17,000 is paid, there technically is not an overpayment/credit balance. The hospital acknowledged that the EOB they received from OSCAR stated "no patient responsibility – patient owes zero." The hospital says they are trying to override their policy to issue the refund check, but I want to keep the heat on because my daughter and son-in-law have incurred thousands in unpaid medical bills, and that overpayment refund of $6,100 is much needed.
I called the hospital countless times and could not get a call back until I faxed a letter to the CFO of the hospital. Within an hour, I got a call back and since that time, the person handling this matter has been communicative, but he doesn't have much authority and always has to go to his supervisor. That takes weeks on end.
They paid the $6,100 with their credit card – maybe disputing that charge will move things along faster?
Any thoughts or recommendations?
Thanks so much!
I work for a DME company. If we receive an overpayment from an insurance company and we notify the insurance of the overpayment, what is the statue of limitations they (the insurance company) has to come back and request those funds before they are considered 'ours'?
My company issues refunds within 60 day for all overpayments/credit balances regardless of the amount. If these refunds are not cashed, we do our due diligence and try to find the owner of the medical overpayments. If we cannot find them, Michigan does not require you to send payments less than $25. Can we at this point we void the check and bring that money into income instead of reporting it to the state? We are concerned with CMS or any other regulations other than the states escheat laws that this will be an issue. Thanks!
I am at a hospital in Texas. We have some patient overpayments that originated from a credit card payment. Can we cut a check back to the patient or do we have to refund the credit card? I was told years ago that it had to go back to the card otherwise it would be considered a loan.
We have an insurance company demanding reimbursement for 'overpayment' on several patients' accounts. It was discovered that they (the insurance company) had two fee schedules, and were using the wrong one when paying us. We called several times trying to figure out why the benefits were not being paid at the amount that was estimated, until eventually the insurance company figured out it was using the alternate schedule that did not match the one they sent us. Should we have to pay them back for their error when they sent us one fee schedule and used another….?? They never would have found their error had we not called several times to point it out to them.
I work for a third party administrator. There was a computer glitch and a dental claim was accidentally processed for a different person who was not a patient of the provider. The provider's office cashed and deposited the check, knowing it was not their patient. They called to let us know. An overpayment letter was issued to their office the same day of their phone call. I've sent them two requests. They are refusing to refund us back. They applied the payment to one of their patients, who the claim was intended for. They think this is an "even exchange." It's not, due to deductibles. In fact, the provider should be paid more. The correct patient already satisfied their deductible earlier in the year. We told them the claim for the correct patient will not be processed until we receive the refund. I now have to call the patient to let them know the claim is pending. I have no idea if the DDS charged the patient a balance. If so, it will be incorrect. The DDS office manager is playing games when I call her. She will leave messages to call her at the DDS office. I will return her call within seconds, and she is not there, she's actually calling from her house. They think this is a funny, laughing matter. I work in northern Calif. The DDS is in San Francisco. What would you suggest my next steps would be? We no longer have a claim manager, I'm a Dental Claim Examiner. I've never had anyone refuse to pay a refund in the 8 yrs I have worked there. I have implemented my own system of getting paid and I always get an overpayment refund within 60 days. Any suggestions would be appreciated. If you could direct me on rules and regs to construct a more legal letter. They are being fraudulent, using funds that is not their's, misrepresenting a patient's identity, and cashed a check for services not performed on a person who is not a patient of their office. Send the DDS a certified letter? Thanks for you help!
Non-Contracted Insurance paid their members claim. They are stating that they forgot to send claim to their "cost containment auditor". They are asking we refund more than 80% of the payment and bill the member for a 2017 claim. Should insurance carrier ask for the payment from their member?
I had a claim for blood work done at an out of network lab. They sent me my HRA funds to pay the lab. They're now telling me they sent too much and I owe them a check for $125, is this allowed???
We recently opened our own Ambulatory Surgery Center, our physicians are the only ones practicing currently at the ASC. We are noticing that based on when claims are submit sometimes the ASC will get paid first sometimes the Physician will get paid first. This is causing our patients to have credits in one system and an owed balance in the other because of pre-payment. Can we move the credit over from one system to the other? Do we have to have the patient's permission? Do we refund the patient their money in hopes they will pay the "other" system? What are you thoughts?
We have received several refund recoupments from an insurance co stating the member did not have active coverage on the date of service, The dates of service are over 5 years old, when we verified benefits we were told they had active coverage, can an insurance co request refund for dos from 5 years ago, I am in Pennsylvania and the statute states none across the board, do we not have any recourse to fight this?
I have a question I got injured on the job and used my insurance because workers comp. gave me hard time. I lost my workers compensation case so my insurance paid everyone accept my anesthesia. I received a bill from them and the contractual amounts was written off and said if my insurance would have paid it would be $618.00. I called my insurance company asking could they help me with the bill cause it was workers comp. and I couldn't afford it. They called me back a week later to inform me they are going to pay the full amount and intentionally send them an overpayment of $3500. She said something about a clause in my contract and I did nothing wrong and everything by the book so an overpayment is being sent and the provider will know what to do with it. My question is who is getting the refund? Me or the provider and why would they intentionally send the overpayment to my provider?
How would you request a refund to AHCCCS if the Pharmacy states your son's medication is denied because he has a secondary insurance; he has no other insurance? We have had to out of pocket for his medication until AHCCCS was able to remove the secondary insurance that they had listed in his file.
My patient has dental insurance effective 6//9/2017 and medical effective 6/19/2017
Both are under the patient's mother. I filed dental first and received 2000.00, sent EOB (with the primary payment as a line item on the claim) to the subscriber to file. A narrative was requested so I completed it and sent it in.
The total claim was 2820.00
Primary Dental paid: 2000.00
Medical paid: 2505.00
This leaves a credit of $1685.00
I called the medical carrier and they were adamant about being primary and that they would have paid the same amount regardless of dental insurance. I have a reference number and names of two reps I spoke with.
Should I contact the dental and let them know the medical paid and send the credit to them?
I don't feel I should send the credit to the patient.
I have a slightly different scenario right now as a patient. We received a check from our health provider and when I called to ask why, they said it was an overpayment from insurance. At the time I had my primary insurance but also secondary/gap insurance. Nobody seems to be able to clearly explain what happened, best I can figure out insurance paid out their initial coverage amount, then secondary/gap insurance paid what was outstanding after primary insurance's initial payment, but then primary insurance paid the health provider more. Health provider then sent me a check for the balance of the overpayment.
Today the health provider is asking for that money back, because the secondary/gap insurance company is now asking them for it back (gap insurance must have found out primary insurance eventually paid out more).
The original medical services were provided 8 months ago, we received the check about 5 months ago. Are we on the hook for the returning their erroneous payment to us?
I recently noticed that I've overpaid my chiropractor about $292, I'm trying to get a refund. He told me that he can give me credit for future visits. He clearly sounded like he didn't want to give the money back. I told him clearly that I want the refund not credit as I wouldn't be going back. He told me to give them a week to file claim for my final visit with the insurance, which they didn't file yet even after two weeks. I have been going to that facility from April and I was the one who noticed the overpayment and it's frustrating to deal this situation. I already wrote to my insurance that I would need their help by speaking to the chiropractor office if they don't return my calls coming week. Is there anything else I should do in this situation? I'm from Georgia. Your suggestion on this would be greatly appreciated. TIA
I'm trying to get a refund from my chiropractor for $292 which I overpaid during my initial visits. They got paid by my insurance and also by me, when I found out about this overpayment recently, they are now offering credits for future visits which I don't need. When I called them couple of weeks back, they told me that they will file the claim (which was only for my final visit, all other claims are complete and they r paid by my insurance) and contact me after a week, send me the cheque for the overpayment. As they didn't call or return my calls, I wrote to my insurance whether they could help me by speaking to them. I find them very dishonest and won't be returning to them for service. I paid through credit card and I'm from Georgia. What are my options to get my money back? Your suggestions are highly appreciated. TIA.
I have a question regarding copays/coins. We collect our copays upfront. However an insurance company comes back refusing to pay the claim, for instance, authorization was not given or patient seen over visit limit. Are we allowed to keep the copay or coins that the patient would have paid initially or do we have to give back to patient?
Does this article pertain to Minnesota regarding refunds? I am going through some OLD files before I worked here and have found a file that has a credit – wondering what to do with old credits I may run into. (no known phone number for patient) Making sure we follow the refund laws in the future as well. If an insurance company paid differently (more) like we collected a copay but insurance paid 100% so money will be due back to patient. What is time frame refund the patient for MN or can it sit in their account until they return for care? Thanks for any help!
Our hospital owns a number of physician practices. If a patient is due a refund and requests that we transfer the refund to pay on her hospital account, is that permissible?
Can you point us to a regulation regarding the threshold amount? I cannot seem to locate anything with a specific dollar amount. Everything I find just says "a reasonable amount."
We bill for a doctor in California and we just received a letter for over payments for claims from 2013-2016. They are all stating that the patients had a different insurance. We don't know why they would process the claims if they couldn't identify the patient and to this day they are still paying on some of these patients. Is there a time limit they have to ask for a recoupment since some of these claims are over 5 years old.
If a patients never paid on her older accounts and overpays in a current account (all under the same MR) Is it legal to transfer credits and zero-out those accounts before refunding the patient?
We have a high deductible plan. The hospital (WV) offered a 20% discount on pre-registration for a prepay amount they had calculated with no refund conditions provided. We accepted the offer and paid through a credit card $5000. An ensuing refund was due for the overpayment (90 later). The final statement reflected a significant loss of that discount on an after the fact accounting adjustment. Particularly disturbing was a loss of discount for an HRA payment to the provider paid after the account was already reflecting a credit balance. (The HRA had previously paid us for claims we would file for excess deductibles paid by us.)
Thank you for your thoughts. They will not discuss the loss of the discount and tell me, "That's the way it is."
I write this as a patient, living in California. I received a letter from my insurance provider, dated 8/14/18, requesting that I return $4,020, the amount which the insurance company says they overpaid my surgeon (a contracted provider for the insurance company) for my procedure of 8/28/17. The letter states: "this claim was received after a previous claim was processed, and adjusted, using CMS MUE limits." There is a good deal more verbiage in the letter, but essentially the insurance paid twice for the same service.
One important detail: after my surgery, the insurance company settled provider claims by mailing payment checks – to ME. I deposited these insurance checks into my bank account, then immediately sent personal checks for the same amounts, to the indicated providers. I kept none of the funds sent by the insurance company.
Before I call the insurance company, I was hoping to get a better idea as to where I stand with regards to this situation. Am I obligated to repay the insurance company the $4,020, or can I request that they collect directly from the provider? If I do have to pay the insurance company, are there any specific guidelines, or state/federal statutes, that could help me in seeking to recover the money from the physician provider?
Any suggestions or input would be most gratefully appreciated!
Hello – I just submitted a query re. a $4,020 payment my insurance company is requesting from me.
I just wish to add a clarification: I mentioned in my query that the surgeon was a contracted provider for the insurance company. Thinking on this some more, I realize that I cannot say for certain whether this is indeed the case, or not – I had just assumed that he was. Sorry for the incorrect assumption.
I received a request from GEHa insurance to return of an overpayment issued to a provider. services were rendered to my husband and I was the primary insurent . GEHA insurance made payment directly the provider without my involvement .
I sent them a letter pointing out the fact that I have never received any extra payment and not liable for the debt and also that mediation wirh provider to whom they overpaid should have been next step according to their manual
…. 3 years later i am receiving collection letter! Is what they doing legal? where should I send a complaint letter ?
I didn't read through all of the comments, please forgive me if this has already been asked, but is it legal to merely notify an insurance company when an overpayment is discovered and wait for them to process a recoupment? We do billing for providers in 13 states and am hoping there is a national guideline rather then state by state mandates.
Co-pays are collected routinely at TOS for either Specialist or PCP. Many time the Insurance Company will pay the claim with a PCP co-pay due from the patient, rather the a specialist. What are the legal obligations of the practice to inform the Insurance that their claim was processed incorrectly? What if the time frame for look back of claims has expired when this has been identified. Should the Patient be refunded the difference between the Spec Copay vs the PCP copay. Will the Insurance company have any legal right to recoup their original payment and re-process the claim with a higher Patient responsibility after the timely filing has expired for the Carrier? The practice is in NY
I work for a large group of doctors and everyday I see refunds from 20.00 to 2500.. and some of these are 3-4 years old . We are told not to tell the patient, this money is owed to these people and when it comes to the families and older patients I get mad. I don't know what can be done, I need my job but have been watching this go in for almost 2 Years.
What if an over payment refund is due to a patient, but it is returned with no known address and the phone number on file has been disconnected? How are we supposed to handle the credit balances at that point?
If a claim was denied for timely filing and the patient made a payment (copay, coins, or deductible) toward that visit, should the payment be refunded to patient or can the provider keep the payment toward that visit?
How can you collect money from a hospital that says they have put it back on a card you made payment with initially, however, you've never had the card they claimed you had. They are refusing to reimburse monies due and will not allow conversation with their manager.
I live in Oregon. Our pharmacy billed the wrong insurance company, the insurance company paid the bill. Insurance company is now coming after us for the money. Pharmacy has admitted they billed the wrong insurance, the health insurance has admitted that they shouldn't have paid but we just got sent to collections over this by the insurance company. Our real insurance company has said they have no issue paying for the prescriptions but they don't even have a bill or anything from the pharmacy. Can the health insurance come after us for their mistake and the pharmacy mistake? Any idea how to resolve this? Thanks in advance.
I have a payer insurance patients through a Medicare Advantage program. The plans recovery department is stating that Medicare's policy is 3 years from the date of service, while Arizona state law states they payers have 1 year. Can you tell me which of these should be followed? Does state law trump Medicares rules and regulations?
My company has care sites in Colorado, Kansas and Montana. I am curious to know what industry standards are for declining a refund request when the payor has now identified another payor as primary. I believe the standard is 6 months but I would like to understand what others are doing as well.
When a patient has two valid insurance policies in force (premiums paid by the patient) and both pay as secondary according to the terms of their respective contracts, do I refund one of the insurance companies, the patient or do something else as no one paid "in error."
We are an oral surgery practice in MN. We've received a primary payment for wisdom teeth extractions under both a patient's medical and dental employer plans as the patient has benefits for this service under both. Usually Medical pays primary for these services & and dental coordinates paying secondary and in other rarer cases the dental is determined to be primary and the medical coordinates with dental to pay as secondary. We first sent notice to dental with the medical eob that we felt they had overpaid and should reprocess as secondary and send us a refund request for the appropriate overpayment amount. Dental sent us documentation stating they paid correctly per the plan's cob policy as they don't coordinate with medical. We then sent a similar notice to medical with the dental's cob determination and eob asking they coordinate with medical. Medical responded that they reviewed and determined they paid correctly as primary. We know we can't keep the overpayment. The patient paid zero in this case as per the patient's benefits and standard coordination, we expected their patient responsibility to be zero. At this point do we keep combined payments up to the medical allowed amount so patient has no patient responsibility and refund the remaining overpayment to the Stat of MN's Unclaimed Property's dept. OR can we refund the patient the remaining overpayment?
I am due a refund for two dental claim from visits in August and September and that dentist has cashed the checks for these two claims and acknowledged that I am due a refund. I was then seen again in October wherein I paid the correct out of pocket amount and that claim is pending. The dentist's office has stated that until they receive the money for the last date of service in October and all claims are paid they will not refund me the amount overpaid by me for the first two claims. Is this legal to hold my refund? At this rate, when I go back for my six month checkup another claim will be outstanding and I will never get my refund due to me.
Please advised, I am a refund specialist for a billing company.. I have sent letters to insurances such as Aetna, UHC, Amerigroup, Automated Benefits Services advising them of over payment for reason as dup payment, codes voided, wrong code billed. However these insurance and other have NOT taken the money back. Then in order to clean up my A/R I send a check to them only to have it returned… our we allowed to keep the money than? We have proof that we tried to refund insurance
#Commercial payor only NOT Government
My adult daughter (27 at the time) was involved in a horrific rollover MVA in August 2017 here in Florida. Billing personnel came to her room and said that her deductible was $3,000 through her health insurance Aetna, and if we paid that week we'd get a discount and just have to pay $2,400, and our daughter would have no other deductibles for the rest of the year. My husband (her stepfather) did pay on his credit card.
Fast forward to July 2018. Her insurance company EOBs weren't paying bills in 2017, saying they were being applied towards her deductible. When I called Aetna and questioned it, they said for her August 2017 hospital stay there was NO deductible per her plan and, even if there was, it was only $1,000. They said we needed to get our money back from the hospital.
I contacted the hospital billing department in July 2018 and in August 2018 the billing office acknowledged there was an error and we would receive a refund by check since the credit card had been canceled and a new one issued due to odd transactions. On November 27, 2018 billing said we had to email them a copy of the credit card statement showing he made the payment, and we did that same day.
Today (12/27/18), after hearing nothing, I contacted the Patient Accounts department and was informed that since my daughter had other hospital visits (ER visits) in October of 2017 and April of 2018, they took the money we paid and applied it to those bills. I told them she is an adult and we are not responsible for her bills. This also leads me to believe they knew before I discovered it that the money was originally collected in error.
I am not sure where to go from here. I had previously contacted the hospital administration office, and they gave me the direct number to the billing supervisor; she's the one who asked for the copy of the credit card statement in November. I feel we are entitled to a refund. Do you have any advice?
I work for a chiropractor in NJ who charges upfront for treatment plans ranging in price from $9,000 to $16,000. If the patient pays one lump sum, he takes 20% of the grand total. For example if the treatment is $10,000 and they choose to make a one time payment, the total is $8,000. If the patient does not continue with treatment and wants a refund, he subtracts the number of visits x the price/visit from $10,000 not $8,000. He also claims that it is illegal to give the refund prior to 90 so that all insurance claims have been settled. If the patient has no insurance claims outstanding, is it necessary to wait the 90 days? Also, he uses credentials on his business card, website and flyers that have expired. Could he loose his license for that?
I had a credit on my account for my Dr since 4/18, I was unaware of this credit until 1/19 and they will not release my balance to me. There is one dr appointment that is still pending on my insurance, at MOST I would owe them $30 and my balance owed to me is over $300, originally it was almost $900.
What can I do if they refuse to release my funds and how much time do they have to do it, last time they said it took 80 days? I'm in CA if that matters at all.
If a provider that is in- network and has a contract with the insurance company, tells the patient they pay upfront the full "retail" price or no services will be rendered and then receives the contacted amount from the insurance company which is only half the "retail" amount 400 compared to what was actually paid by patient 1,040. Can the in-network provider keep the additional amount that was paid even though they have a contact to accept the in-network amount? If they are required to give the excess back and refuse, what can be done?
One of the insurance companies that I have a contract with has sent me a letter of demand for a refund of "overpayments" of over $20000.00. All these claims are from 2014 (Five years old!).
Is this legal to do?
What should I do and are there any legal ways to dispute these FIVE year old "overpayments" that are being sent to me NOW!
Thank you
Really Helpful..thx
I am enrolled in Medicare's Qualified Medicare Beneficiary (QMB) program of which my QMB benefit is paid by Medicaid in my home state of West Virginia. I had to seek medical care while visiting Tennessee in July 2015. I was continually billed by Vanderbilt Hospital until I was forced to pay any and all deductibles, co-insurance, and co-pays. I was not aware of my QMB billing protection and rights. Can I get a refund of charges paid since the statute of limitation on medical debt is 6 years in Tennessee and 10 years in West Virginia?
I live in Kansas and currently on disability. I have Medicare (primary) and 2 secondary (UHC through employer & BCBS medicare supplemental). I had to purchase BCBS as a direct pay premium to help pay for my medical needs. Both secondary companies don't coordinate so at times my various providers receive an overpayment. Reading through these comments am I understanding that the overpayments should be refunded to me? I have called one of my providers and explained this and was told it's insurance fraud for me to request a refund of overpayments since I didn't pay the provider directly. Please advice. Thank you!
I received a refund, which I wasn't aware I was due, of $15.81, on August 12, 2019, for an initial and final office visit conducted on July 31, 2017. Is it unusual for a refund to take two years to receive?
We are a specialist in California.
We collect copay's upfront for HMO's clients, per insurance card. When we get the EOB's at times it states the client didn't have a copay. Do we need to refund every client? or Can put set a refund threshold?
Also, what is the statute of limitations for clients to collect copay from a specialist in California?
Thank you!!
We are an MSO and paid a claim for one of our Hospitals to a contracted provider made a duplicate payment on a claim. We did not notice this duplicate payment until after the 365 days of payment date. I was told that for duplicate claim payments we do not have a time limit on requesting refund on any duplicate claim payments. Is this correct? Thank you so much!
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Becoming a Morning Person in College & How I did it!
At the start of this semester, I set a goal for myself to become a morning person. I've always been comfortable waking up at an early hour, but in the past, if I woke up early I would have to nap in the afternoon. I felt like taking naps in the middle of the day made the whole "waking up early thing" counter-productive. To me, being a morning person means waking up early (obviously) but also having the ability to be productive and sustain their energy throughout the day.
By following the tips below, I can now successfully say I am a morning person. I wake up at 6 am every day and I work on my blog and study every morning before I go to class. I haven't taken a nap in weeks, and I feel 100 times more productive now that I wake up early. Also, I wanted to note that I wake up at 6 am even if I don't have anything planned until 11 am. It gives me more time to relax in the morning and that way my body says consistent with waking up at the same time.
The Night Before
Pack your backpack, lay out your clothes, and get ready the night before.
This tip reminds me of something my mom would always say when I was in elementary school. Getting your bag together and figuring out what you're going to wear the night before will help you be productive in the morning and ensure that you won't forget anything for class. Also, if you have a roommate, you'll be less likely to wake her up when all your clothes are laid out rather than digging through your closet for a cute outfit.
Count your sheep and get a good nights sleep.
Everyone is different, but in order for me to function the next day, I need at least 7-8 hours of sleep a night. Anything less than that and I'll be a zombie the next day. I'm not a night owl at all, so I love going to bed early! There's no better feeling than curling up in your warm bed after a long day. If you struggle to fall asleep, I recommend reading a book (not a textbook!) in bed rather than checking social media on your phone. The light your cell phone emits makes it harder for our bodies to relax and get ready to sleep. If you have a roommate who stays up till the crack of dawn, try using an eye mask and earplugs so they can do their thing, and you can do yours. Being able to have an efficient night's sleep is critical to becoming a morning person.
The Morning Of
Forget snooze!
It's time to get out of bed the minute your alarm goes off. Hitting snooze every five minutes will make it so much harder to get your day started. I only set one alarm on my phone so I know I have to wake up when it goes off to avoid sleeping through my class! I've heard of some people putting their phone on the other side of the room, so they have to get out of bed to turn it off. Do whatever works for you, just make sure that you get up!
Make breakfast exciting
Not going to lie, one thing that gets me out of bed in the morning is knowing that I have avocados in my kitchen and that I'm going to make avocado toast and eggs as soon as I get ready. Have some of your favorite breakfast foods in your kitchen that will help make your morning ten times better. Also, I recommend making something that is healthy and will provide you with energy throughout the day. I have a blog post here with two acai bowl recipes that are perfect for breakfast, check it out!
Don't Rush
I'm assuming that since you're waking up early, you are going to have some time to do whatever you want. In the morning I make a cup of tea and write in my five-minute journal to help get my day started. I'm going to write a whole blog post about the five-minute journal in the future, but in short, this journal has helped me grow into a more positive and grateful person. I highly recommend it to anyone to add a positive force to your day. Another way to make your morning positive is to play your favorite music while getting dressed or spend some time stretching/doing yoga to wake up. When you wake up, do what makes you happy and that will start your day on the right note.
How do you want to spend your morning?
Have a Game Plan
So your awake, you've made your breakfast and written in your journal, now what? Before embarking on the journey of becoming a morning person, ask yourself, why do you want to wake up earlier? Is it because you want to hit the gym or the textbooks? Or do you want the luxury of being able to wake up before the sun rises? Whatever your reason is, write it down so you can look back at it during the mornings that you don't want to get up. I wanted to wake up early so I could work on blogging. I knew that I didn't have time during the day with work and college, so waking up early to write was the solution I found. I'm so grateful that I decided to do that. I love being able to write in the morning, distraction-free, and it sets me up to have a productive day.
I know this post was pretty long, but I hope it inspired you to wake up earlier yourself and get the most out of your day. It's not an easy process, but it is possible to become a morning person. If you have any questions or comments, please leave them below and I'll get back to you as soon as I can. Have a wonderful Wednesday (and if you're reading this the day it's published, Happy Valentines Day!!) and I'll talk to you on Friday.
A College Girl


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"Education paves the path for the future," said Dr. Luis Pedraja, president of Quinsigamond Community College, the guest speaker at WEC's 8th annual meeting. "…we must find creative pathways that align our curriculums and create a college bound culture not in high school, but as early as elementary school," Pedraja said.
"Worcester Education Collaborative's mission certainly resonates with my own commitments to ensuring student success," Pedraja noted. "Preparing our children for success in college, career, and life is not only a calling, but a duty that falls upon everyone in our community."
You can read Dr. Pedraja's entire address here
Following are more highlights of his talk:
Dr. Pedraja outlined challenges facing Massachusetts educators:
Skilled workforce: Current research shows that by 2020, about 65% of job openings in the Commonwealth will require some college. However, on average we come short of that mark by 15-30% in most communities. The numbers are significantly lower for low-income, minority, and immigrant populations that comprise a growing a number of our community. This gap, unless addressed, will create greater income inequality and could lead to an economic collapse.
The devaluation of education: a growing tendency in our society to diminish the value of education, even to see it as suspect or as unnecessary expense….education is an economic driver. An educated workforce bring industry, increases wealth and buying power, foster innovation, and more engaged in society. Investing in education, is an investment in our future.
It takes a community: We have heard that it takes a village to raise a child; in the same way, I believe it takes a community to educate our students. Whether it is through the creation and expansion of mentoring programs, working with community based organizations to expand wrap around services, or aligning the multiple programs to ensure a seamless pathway, as a community we must take education seriously and be involved in the education of our children –all of our children, regardless of who they are or where they live. The future of our city and community depends on it.
Eliminating barriers: We also need to stop measuring education by the time students spend in the classroom and instead look toward outcomes opening the path for us to explore competency based education and distributed learning models that will increase flexibility and shorten time to degree.