Satute of Limitations for medical billing

[Madolaina]

What is the name of your state (only U.S. law)?North Carolina

I am a state employee with the state health plan.....BCBSNC.
In January 2006 i received stiches and a tetnus shot in an urgent care facility. I never received a bill. This did not seem unusual because the insurance plan at that time covered emergency care with a $50 co-pay.
Today , March 2,2009 (more than 3 years later) I have received a bill and a threat that if I did not pay immediately they would seek legal action.
Is this legal? Is there a statute of limitations on billing?

[ecmst12]

Most likely the SOL is more then 3 years. Was it ever submitted to your insurance? If not, why not? And is the facility participating?

[Madolaina]

Originally Posted by ecmst12

Most likely the SOL is more then 3 years. Was it ever submitted to your insurance? If not, why not? And is the facility participating?

Yes it was filed****************************..I was never billed.

[ecmst12]

If you are just being billed for your copay, then yes you have to pay it.

[Madolaina]

No I am being billed for the full amount**************just to clarify, the BCBS denied the claim 3 years ago.....I don't know the reason**************......whan I went into the Urgent Care I paid the copay and was told that accidents/emergency care would be covered. The deductable was met for that year before that visit.

[ecmst12]

You need to find out why it was denied and whether the facility is in the network or not.

[lealea1005]

Originally Posted by Madolaina

No I am being billed for the full amount**************just to clarify, the BCBS denied the claim 3 years ago.....I don't know the reason**************......whan I went into the Urgent Care I paid the copay and was told that accidents/emergency care would be covered. The deductable was met for that year before that visit.

Urgent Care Centers may not be considered the same as an Emergency Room. Check your policy. Your diagnosis may also have something to do with the denial.

If you knew the claim was denied 3 years ago, why did you wait until you got a collections notice before looking into the reason it was denied?