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Doctor refuses to bill insurance

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Cephus

Junior Member
What is the name of your state? CA

I'm having an odd problem. Over a year ago now, I went in for a routine checkup and they ran some routine tests at a new doctor. They took my insurance information and in fact, did bill my insurance for two return visits I made. I wasn't happy with the doctor so I moved on to someone else.

All of a sudden, I get a bill for $400 for the visit a year ago. I had not had any other contact with the doctor in the year since, now they're claiming it's 120+ days past due (well obviously, they waited a year to send me anything). Since I already paid my co-pay for the visit, the rest of it is something they need to bill the insurance for. Unfortunately, they show no interest in billing the insurance, probably because they'd have to explain why they were so stupid that they forgot to bill it a year ago.

Ideas? I'm tempted to tell them to sue me so they can stand up in court and explain to the judge why they're so stupid.

Thanks.
 


seniorjudge

Senior Member
I'm tempted to tell them to sue me so they can stand up in court and explain to the judge why they're so stupid.

Pray that this cup may pass from you since you are 100% wrong here.

Pay the bill.

Then you take it up with your insurance company.
 

justalayman

Senior Member
Sorry judge but I believe more info is required before any action is taken.

If the doctor was a signatory of a PPO, the doctor may not be able to bill the patient at all. It would depend upon the contract between the doc and the insurance company.

as well, even if the doctor is not obligated by some contract with the insurance company, IF they had agreed to bill the insurance company and failed to do so, I believe the OP can claim under the doctrine of promissory estoppel the debt, or at least the portion the insurance company would have paid, as being not collectable from the patient.

This is because the OP was unduly injured based upon the doc's office failure to submit the insurance claim within a reasonable time so that the insuracne company would have paid some protion of it. An insurance company often will not accept claims more than 1 year old so basdd upon that, the doctors office is responsible for their own loss.

but, there is also the possibility none of the above situations are applicable and if so, OP simply needs to pay the bill.
 

Hydroshock

Junior Member
Keep in mind

being 120+ days late, if it was sent to a collection agency, be sure to bring up the credit reporting in the issue. If it shows up on your credit report and it turns out you are not liable for the debt, they can get in trouble for that as well.
 

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