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#1
Old 12-09-2013, 10:07 PM
Member
Join Date: Feb 2005
Location: the Keystone State
Posts: 14,053
How long after services does a medical provider have to send out a bill?

I got a hospital bill today from an ER visit back in March of 2012, 18 months ago. First I called the hospital to find out what this was actually for & confirmed my insurance company paid (I don't remember ever getting an EOB either) An insurance that I haven't had for over a year, from a job I have worked at for the same time frame. I called the insurer and explained what happened. HIPAA verification was a little tricky since I no longer have an ID card or any paperwork, but they were very helpful. The CSR explained how my claim paid out, verified that the hospital submitted it within days of my ER visit and was paid a week later when the EOBs were sent out.

So how did it take the hospital a year and a half to get around to send out a bill (for several hundred dollars which is due in a week )? Is there any there any kind of statute of limitations on this? Nothing on the bill mentions any other notices being sent out. I was too flabbergasted to ask why it took them so long when I spoke earlier, but I am going to call tomorrow. Also there's no way I'm paying until I look at the EOB from my insurer, which might not arrive until after the due date. The really weird part is the hospital and the insurance company are telling I owe different amounts; with the hospital's being lower by about $150.

Even the CSR though that was strange (& agreed that waiting this long to send out a bill is ridiculous). I mean I've worked for an insurance company dealing with providers, and I never saw a provider file that didn't have a timely filing limit of a year. I mean if the insurance company doesn't have to pay anything if the provider waits over a year to bill them why should I?
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#2
Old 12-09-2013, 10:10 PM
Charter Member
Join Date: Jun 2000
Location: Houston
Posts: 14,199
Sounds like typical inefficient billing to me! DO NOT pay it. Keep making calls to the hospital and the insurance company. BEST: Get a conference call going so they can talk to each other.
#3
Old 12-09-2013, 10:42 PM
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Join Date: Jul 1999
Location: Hutchinson, KS
Posts: 3,504
If I understand the OP correctly:

1) Insurance paid their part and the bill is for the part alphaboi867 owes.

2) The bill is for $150 less than the CSR said the EOB shows.

I don't know if there is any time limit for sending a bill or collecting the debt, but I do remember years ago seeing Judge Wapner tell a defendant that not receiving a bill was no excuse for not paying a debt (based on California law at the time, of course).
#4
Old 12-09-2013, 11:19 PM
Corellian Nerfherder
Join Date: May 2000
Location: Brookfield, IL
Posts: 11,689
I was hospitalized eight years ago, for chest pains. It wound up being a 24-hour stay, with a series of tests. They took my insurance info when they admitted me, but I never received a bill from the hospital. Then, about eight months later, I got a letter from a collection agency, seeking payment of my share of the bill -- this, despite the fact that the hospital itself had *never* sent me a bill of any kind.

I called the hospital's billing department, and asked them why they never sent me a bill, but chose to, instead, involve a collection agency. Their answer: they had expected me to somehow determine not only (a) figure out how much I owed, based on my insurance company's arcane EOB statements, but (b) proactively figure out how and where to send that money to them. In short, they considered it to be my fault to have not hunted them down in order to pay my bill.

Last edited by kenobi 65; 12-09-2013 at 11:19 PM.
#5
Old 12-09-2013, 11:58 PM
Charter Member
Join Date: May 2000
Posts: 27,298
If you want some practical advice, I can give you some because I have been through this twice including once in the past week. I got slapped with a collection account on my credit report two weeks ago for a medical bill from 2009. How did I know that? It is easy, use creditkarma.com . Anyone can and it is legit and completely free. I depend on a keeping a very high credit score for lots of benefits so it really cramps my style to have negative things on mine.

In this case, they claimed I owed $509 for something I had never heard of and shouldn't have applied anyway because I had full insurance for all of 2009. I called the collection agency and was offered roughly the same way out as kenobi 65. They wanted me to call my insurance carrier from 2009, figure out what happened and either have them reconcile the bill or I could pay a reduced payment of half the amount. There was no way I would or could do that just based on the information they had.

Let's skip to the pro-tip here. I shouldn't have even called the collection agency. All I had to do was go to Transunion's website (transunion.com) and order a full investigation of charge including a description of why I thought it was unjustified and/or fraudulent. That takes about five minutes to do. They closed the investigation less than a day later saying that I didn't owe anything. It can never be included on my credit report again and no one can ever contact me about it ever again by law. The two other credit agencies are Experian and Equifax and they cross-talk to one another.

Don't fall for the bluff and don't make any payments or promises. Just state over and over that you have "no knowledge" of this bill and keep it at that. The burdeon of proof is on them in cases like this and they won't be able to do it. They are just hoping suckers fall for their vague but toothless threats. Dispute it with the relevant credit reporting company and the chances are outstanding that it will be cleared forever and no one can ever contact you about it again by law.

Last edited by Shagnasty; 12-10-2013 at 12:02 AM.
#6
Old 12-10-2013, 12:12 AM
Guest
Join Date: Dec 2007
Location: California
Posts: 2,016
Happened to me a few years ago w one of my kids. But this was an out of state ER so I signed on the dotted line that I would be responsible for all expenses and could seek reimbursement from my insurance co if i had one. We were on vacation, my kid was bleeding and needed stitches.. wtf else was i to do?

Only problem was we got home and i quickly forgot about the bill and got on with my life. 18 months later, I get a past due bill from the hospital threatening to take me to collections. But the insurance company I was supposed to collect from had long since been replaced. I was in a hectic phase at the time when I had more money than time, so I bit the bullet and paid the bill just to make it go away. But if that happened today, I'd fight it tooth and nail. Total bullshit.
#7
Old 12-10-2013, 04:46 AM
Guest
Join Date: Jul 1999
Posts: 10,667
I had a doctor call the other day about a one-time visit over two years ago (I was interviewing OBs and had had an exam). They wanted me to pay $200 for the visit. It turned out they had never filed it with my insurance and never billed me. When I pushed just a little, they dropped the whole thing. It was crazy.
#8
Old 10-26-2016, 06:19 PM
Guest
Join Date: Oct 2016
Posts: 1
we don't have to pay

My wife's doctors performed a long series of treatments and told her at the start that the 'Trial' was totally covered by Medicare and our secondary insurance. At first Medicare paid then stopped. When they stopped so did my secondary. After several months we go a letter from Medicare stating that the 'Trial' was not approved and no payments will be forthcoming. Furthermore Medicare wanted their payments returned and any payments collected from us are to be returned. We NEVER got a bill from the physician and never paid him anything. The letter also indicated that we are not obligated to pay him any money...ever.

I've saved every document from Medicare & my secondary.

My question is: If Medicare (in writing) tells me I don't have to pay, how long does this doctor have to do anything...vis-a-vis...file a law suit against us requiring me to pay big bucks for a lawyer...even though he's wrong as a Medicare provider.

Last edited by [email protected]; 10-26-2016 at 06:21 PM.
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