I live in California and work as a Claims Analyst. I have been disputing an invalid recoupment for one patient and was completely shocked to find that they took the money from a different patient’s claim payment. My co worker emailed me the EOB showing what happened and was asked to write an appeal. I am told that this is not legal, but would like to verify this before I respond. I have found information showing that they can take from future reimbursement of the same patient but, not nothing showing that they can take from reimbursements of a completely different patient. I have not written a letter like this before and need assistance on finding California Statutes that can be used for this situation and others. Any assistance would greatly be appreciated.

Thank you,

Corine