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  1. #1

    Default Can a Doctor Bill a Patient for a Payment Denied Due to Late Submission to Insurance

    My question involves collection proceedings in the State of: california
    I received medical services in 12/2012, I received a bill from Doctors's office approximately 6 months after. I spoke to office manager and she said insurance company denied payment because it was not received within their 90 day submission time frame. Office manager said claim had been submitted within the time frame and that the doctors office seems to have this issue with this insurance company in which claims are not received. She told me they would not be pursing me for charges and if I can contact insurance company.
    I called insurance company and they stated I'm not responsible.
    I'm no longer a patient as of early 2017, and I receive a bill for the unpaid charges.
    I continued to see this same doctor and was never asked to pay unpaid charges only until I left office. Office manager refuses to speak to me and the doctor advised me she doesn't handle billing.
    I would like to know if doctors office have a statue of limitations on billing, if I'm responsible for charges, which would of been covered by my insurance company if only doctors office would of submitted claim in timely manner and/or if they would of submitted proof of doing so.

    Thank you for your time

  2. #2
    Join Date
    Oct 2006
    Posts
    15,497

    Default Re: Im I Responsible for Docs Office Late Claim Submission to Insurance Company

    Your doctor is weaseling out of doing the right thing by not handling this billing dispute himself/herself. I hate seeing that because it means that you will never get the doctor's office to back down from this. It will end up in collections and you will be haunted by it forever unless you either give up and pay it, OR you be proactive and sue the doctor's office yourself once it hits your credit report.

  3. #3
    Join Date
    Jun 2006
    Location
    Massachusetts
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    Default Re: Im I Responsible for Docs Office Late Claim Submission to Insurance Company

    Did the insurance carrier give you something in writing that says you're not responsible? If not, ask them for something. They should be the ones handling this, not you.

  4. #4
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    Oct 2006
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    Default Re: Im I Responsible for Docs Office Late Claim Submission to Insurance Company

    Quote Quoting cbg
    View Post
    Did the insurance carrier give you something in writing that says you're not responsible? If not, ask them for something. They should be the ones handling this, not you.
    I guarantee that the insurance company DID handle it with the doctor's office. The doctor's office is choosing to go after the OP even though its all their own fault that they did not get paid.

  5. #5
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,043

    Default Re: Im I Responsible for Docs Office Late Claim Submission to Insurance Company

    That is indeed a possibility, and one reason it would be a good idea for the OP to get something in writing from the insurance carrier that they are not responsible for the bill.

  6. #6
    Join Date
    Sep 2005
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    98,846

    Default Re: Can a Doctor Bill a Patient for a Payment Denied Due to Late Submission to Insura

    If this is an in-network provider, contact your insurance company -- often they have contractual agreements with in-network providers that the failure to submit a claim in a timely manner precludes the provider from later trying to collect the amount billed from the patient.

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