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  1. #1
    Join Date
    Sep 2016
    Posts
    10,643

    Default Can a Doctor Make a Patient Pay a Bill After Late Billing of Insurance

    A doctor performed medical services for a patient, and was to bill the patient's insurance company. The doctor is in-network.

    More than a year later, the doctor is billing the patient. His office says that they didn't bill the insurance company on time and now the insurance company won't pay, so their billing the patient.

    Does the patient have to pay the bill?

  2. #2
    Join Date
    Sep 2005
    Location
    Behind a Desk
    Posts
    98,035

    Default Re: Can a Doctor Make a Patient Pay a Bill After Late Billing of Insurance

    Typically, insurance companies require that in-network providers submit bills within a specified time frame, and further as a matter of contract bar in-network doctors from billing patients for the insurer's share of medical costs if the provider fails to submit a timely claim. The patient should contact customer service for the insurance company to see if it can handle the issue under such a provision.

    If the medical care provider is not contractually barred from billing the patient, then the practice may bill the patient. The patient bears some responsibility for not monitoring billing and payments, although that may actually be difficult for a patient to accomplish if the doctor is not sending out any bills.

    Start with customer service.

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