Legal Question in Credit and Debt Law in Pennsylvania

Your question leaves out many details. Are you a healthcare provider? In such case, read your agreement. Does it say anything about an insurer recouping over payments?

You ask if its "legal." Why would it not be legal? Its not a crime. As long as we are not talking about a crime, most business transactions between 2 private parties are not illegal.

The better way to handle it is for the insurance company to ask the health care provider to repay the overpayment. However, this is not going to happen. If the insurer owes future money for other patients the logical thing might be for the insurer to simply deduct what it is owed from those payments.

If the insurer's calculations are disputed, then there must be something in the agreement which indicates how disputes are to be handled between the health care provider and insurer. I would start with a letter documenting the issue and indicate what is disputed and why. If that does not work, then seek out the remedies provided in the agreement. If all else fails, the health care provder always has the option to not deal any further with patients from this insurer or in going on a cash only basis. Many health care providers have gone to this method as they can get back to the business of providing quality health care rather than focus on patient billing hassles with insurers.