My doctor didn't file my insurance charges in a timely manner.?

Question

This resulted in me having a large, incorrect balance. She has since filed charges against me in a court of law for unpaid medical bills. I don't know how to expain to her the chonology of the error,although I have it documented by the insurance company. What type of professional do I seek to aid me in this issue? Is there such a professional as a medical claims specialist? If so, where does one find such a person?

Answer 1

you will have to take that up with yur doc

Answer 2

Well, you are talking two different transactions here - 1. the services your doctor rendered, which YOU are responsible for paying for, and 2. reimbursement of either you or the doctor, from the insurance company.

She is entitled to collect in full any unpaid amounts, FROM YOU. It is ultimately YOUR responsibility to make sure the insurance company pays the bill, NOT HERS.

You can hire a lawyer (the only kind of professional that helps you in court), but you're going to lose.

Did the insurance company finally deny the claim? Did they deny it because it was filed more than a year after service? Sorry, if that's the case, this is YOUR fault. The doctor should have sent you an invoice (bill) for the service within a month or two of performing it. The very first time you got the bill, you should have called the insurance company to see what happened. My guess is, you just threw the bill away, figuring the insurance company would pay it. That is going to cost you, my friend!! Because that first bill was your indication that there was a problem. A call to the insurance company THEN would have told you that the claim wasn't filed, then you could have called her office, had the claim filed (probably a clerical error on their part), then the insurance company would have paid.

You do need to keep up on these things yourself, sorry! I'm sure that's not what you wanted to hear.

Answer 3

If your doctor had your proper insurance information at the time of service and did not adhear to the plan's timely filing rules, they can not bill you. They have to take it as a loss. They should NOT be suing you for payment.

If they did not have the proper insurance information at the time of service or within ten days thereafter, sorry. You've got to pay. It's your responsibilty as a patient to ensure providers of service have the proper information.

Ask your insurance company for proof of filing of your claims and take it to court with you. The law is on your side in this case. Doctor's offices are supposed to know what their timely filing limit is and they can NOT bill the patient if they miss the boat!

Medical Claims Specialists are often the claims processors, in my experience. I would look for a patient advocate - there is such a society. Contact your local medical society (they're in the phone book) and see if they know anyone who can help. You can also file a complaint with them about your doctor's office.

Good luck!!!