Results 1 to 5 of 5
  1. #1

    Default Collection Company Calling On Three Year Old Medical Bill

    Hi,
    I am writing for a friend who incurred a medical debt in California. I have some experience dealing with this, but not in California. Here is the situation: He had a procedure done 3 years ago. He thought his insurance covered it and has heard nothing about this until recently from a message left by a collection agency. He contacted his insurance company to pay it and was told this was not a covered procedure. In my state there is a statute of limitations... anyone know what it is in California? Also In my state, if you talk to the collection agency and agree to make payment arrangements, the clock for limitations starts all over. It is a large bill and now he has no income coming in. I have told him not to talk to them until he figures out what to do, and then ask them for a validation of the debt. I am wondering , though, if the statute to collect is running out and if this is why he is now being contacted. Does the Doctor who ordered the procedure have any liability because he DID submit his insurance card at the time? I am assuming the medical company wrote off this debt and then sold it to a collection company OR
    the collection agency obtained the info by other less "legal" means because of the time frame and there has been some bad press about this company. They call constantly and he is really stressed. Any help? Thanks a lot

  2. #2
    Join Date
    Oct 2006
    Location
    supratentorial region
    Posts
    818

    Default Re: Collection Company Calling On Three Year Old Medical Bill

    Did the insurance company tell your friend when the claim was submitted by the treating Physician? He can ask for a copy of the explanation of benefits which will indicate the date it was received and "paid".

    Since it was a non-covered service, your friend is responsible for the bill. He received a service and the Physician deserves payment.

  3. #3

    Default Re: Collection Company Calling On Three Year Old Medical Bill

    Quote Quoting lealea1005
    View Post
    Since it was a non-covered service, your friend is responsible for the bill. He received a service and the Physician deserves payment.
    Although I somewhat agree, in many cases physicians are suppose to get pre-authorization from the insurance plan to perform procedures. If the procedure was "non covered" you friend should have been told this up front and maybe even signed an ABN (advanced beneficiary notice)or something to that nature which let him know he would be responsible for any non covered services. It is up to physicians, patients, and hospitals to make sure services are covered. As Lealea said, get a copy of the EOB. Then go from there.

  4. #4
    Join Date
    Oct 2006
    Location
    supratentorial region
    Posts
    818

    Default Re: Collection Company Calling On Three Year Old Medical Bill

    Quote Quoting phillipatomus
    View Post
    Although I somewhat agree, in many cases physicians are suppose to get pre-authorization from the insurance plan to perform procedures. If the procedure was "non covered" you friend should have been told this up front and maybe even signed an ABN (advanced beneficiary notice)or something to that nature which let him know he would be responsible for any non covered services. It is up to physicians, patients, and hospitals to make sure services are covered. As Lealea said, get a copy of the EOB. Then go from there.
    If the Physician is not contracted by the insurance company, he/she is not obligated to obtain an authorization for treatment, nor will any referral/authorization be recognized or honored by the insurance company.

    Ultimately, it's up to the PATIENT to understand their insurance policy.

    ABN's are for Medicare recipients. Undoubtedly, when OP signed their registration paperwork with the office, there was a paragraph regarding payment of non-covered/non-paid services.

  5. #5
    Join Date
    Apr 2007
    Location
    Il.(near StL,Mo.)
    Posts
    5,252

    Default Re: Collection Company Calling On Three Year Old Medical Bill

    I agree. The patient is responsible for all bills not covered by insurance.

    1. Sponsored Links
       

Similar Threads

  1. Debt Collectors: Collection of a Four Year Old Medical Bill in New Jersey
    By flyfoam in forum Debts and Collections
    Replies: 1
    Last Post: 06-28-2010, 05:02 AM
  2. Debt Collectors: 2 Year Old Unknown Medical Bill Sent to Collection and Now Notice of Civil Hearing
    By sbm in forum Debts and Collections
    Replies: 2
    Last Post: 08-21-2009, 04:10 PM
  3. Debt Collectors: Collection Over Medical Bill
    By fredup in forum Debts and Collections
    Replies: 1
    Last Post: 04-27-2007, 09:32 AM
  4. Debt Collectors: Medical Bill Collection After Two Years
    By mtwiss in forum Debts and Collections
    Replies: 2
    Last Post: 10-22-2005, 05:52 AM
  5. Debt Collectors: Collection Notice for Old Medical Bill
    By abbysmommy24 in forum Debts and Collections
    Replies: 2
    Last Post: 06-28-2005, 01:32 PM
 
 
Sponsored Links

Legal Help, Information and Resources