7 answers

Billing Time Limits

I was wondering if anyone out there knows if there is a legal limit to how long a medical facility can wait before billing you for services. I saw a dermatologist a year and a half ago to have 2 moles biopsied, and I received a bill a month later, paid it in full, and even called the derm. office to confirm that they had received payment and that there was no balance on my account. Then a couple of months ago, I received an EOB from BCBS stating that they were denying some charges because they were duplicates. So I went back to the derm. to find out what was going on. I guess they only billed for the removal of one mole at first, then went back to bill for both, then retracted that and billed just for the second one. The end result is that yesterday I received a bill for the second biopsy (done the same day at the same time) that was $100 higher than the bill I paid a year and a half ago! I haven't been back to that doc since May of 07 when these biopsies were done, so it's not for new services. Can they do this? Please tell me there is some sort of statute of limitations on this. I was told 18 months ago that my account was paid, and to all of a sudden get a big bill like this is ludicrous.

What can I do next?

So What Happened?™

Thanks for all of your responses! Ultimately, I'm just SOL. I called the attorney general's office and was told that doctors can bill you for up to ten years after the date of service, as long as there is proof of treatment. And since they technically billed my insurance within the alloted time, I can't get them there. It's more the principal of it, and the fact that I don't have an extra $225 to spend on it. I reported them to the BBB, even though I don't really believe anything will come of it. And since they can't send me to collections if I show intent to pay, I'll send them $5 at a time with each bill. I figure that will take about as long as it took them to bill me. And since my office pays the postage, I'm not losing out at all. It's childish, I know, but it makes me feel better. Anyway, thanks again ladies!

More Answers

The medical world is a crock. I went thru a similar situation and they chased me down until turning the bill over to a collection facility. This was years later. I finally as to not wreck my credit. They ran me around until they broke me down. Good luck.

1 mom found this helpful

It happened to me too, but instead of finding out through an EOB, I started getting calls from a collection agency! I had never even received a bill from them through the mail. I was furious. I called the doctors office and gave them an earful. Bottom line....I was responsible for the bill.

1 mom found this helpful

I know a lot of BCBS plans allow until the end of next calendar yr for a claim to be submitted. I would talk with the billing manager at the doctors office and explain how this bill was not anticipated and that you were told your account was paid in full. I would ask if they would waive your responsibility due to the information you were given by their office that your account was paid in full, that they are receiving additional payment from the insurance company and that it would be a financial hardship for you to have to pay additional money at this time. If the person gives you hard time, in a nice way mention that this was their error. Hopefully it may help. Good Luck. And if you have to pay it, I believe that as long as you are making payments to your balance, they cannot send the account to collections. I may be wrong on that!

1 mom found this helpful

Unless you have it in writing that your account was paid up in full along with a receipt listing what was done and billed, there's not a whole lot you can do.

1 mom found this helpful

J.,

I don't know about BCBS, but I know with other carries Doctors only have 6 MONTHS to file a claim. The EOB I received for a similar situation also referenced state law. You might want to call the state attorney general and ask them.

1 mom found this helpful

We are a billing service that assists people with their medical bills. I would certainly be able to assist you. First pull out your other explanation of benefits (EOB) on the initial removal, compare them, dates of service, codes, units, etc. That should all be on your EOB. Then contact your insurance co and discuss with them any discrepancies. They will be able to explain everything to you. The dr's office may have billed it incorrectly. If you would like me to review it you can fax the EOBs, bill from your dr to ###-###-#### attn: B. Make sure your info is on there so we can talk further. Dr's can bill you as far back as they want as long as they can prove it.
Barb R.

1 mom found this helpful

There is a limit to how long the doctor's office has to bill the insurance company. If the Insurance company denies a claim for "timely filing", then it is not your fault, and you should not have to pay. First, I would call your insurance company back to find out if it was a covered service. Why did you get a bill in the first place? Was it because you hadn't met your deductible yet? Were you responsible for only a percentage of the total cost? Then, you should call and speak to a billing manager at your doctor's office, to let them know what your insurance company said. It sounds like the doctor's office doesn't really have their act together as far as billing is concerned. If the charges are duplicate, then it's obviously their fault, and you shouldn't have to pay. If they didn't bill for all or part of the procedure on time, then it's their fault, too. I have some experience with billing and doctor's offices. If you have any more questions or need any more help with this, please contact me. Good luck!

1 mom found this helpful

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