Medical claim filed late

[macajudl]

Colorado

Is it absolutely impossible to get a medical claim paid by a health care provider when the hospital providing the service filed the claim approximately a year and a half after the service was rendered? Have searched for statute of limitations for Colorado filing of basic medical claims - not related to personal injury or malpractice but have been unable to find anything relative to this situation.

[JETX]

Originally Posted by macajudl

Is it absolutely impossible to get a medical claim paid by a health care provider when the hospital providing the service filed the claim approximately a year and a half after the service was rendered?

No********************************************************.....

[ajkroy]

It depends on what insurance it was. Their contracts dictate what is timely filing, Some have filing limits as narrow as 60 days...other have two years. What is the reason for the delay? If you gave the provider all the correct information and they just stuffed it in a drawer, then you do not have to pay the bill. You are also entitled to your copay back, if you paid any. However, if you did anything to prevent the provider from timely filing (incorrect ID #, improper ss#, etc.), then you are stuck with the bill.

A certain amount of responsibility falls upon you, too. Did you check to see that the bill had been paid? Nearly all EOBs are online now and it would be prudent to check them whenever you have a claim pending.

Good luck.

[moburkes]

Originally Posted by macajudl

Colorado

Is it absolutely impossible to get a medical claim paid by a health care provider when the hospital providing the service filed the claim approximately a year and a half after the service was rendered? Have searched for statute of limitations for Colorado filing of basic medical claims - not related to personal injury or malpractice but have been unable to find anything relative to this situation.

Contact the insurance company. If the hospital filed late, per their contract with your insurance company, if this was an in network claim, they may have lost their right to receive the insurance company's portion, in which case you are only responsible for your co-pay. If you didn't present your insurance information at the time of the appointment or if it is out of network, then you are SOL.

This question has been asked several times in this forum (did you do a search?), and this is the response received by the health care professionals that are familiar with contracts and billing.