Secondary was billed as primary, then denied saying claim was filed late

[blunamy]

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

My secondary was billed as primary after my son's surger on 8-8-08. They sent it to collections after the insurance company wouldn't pay. I told the collection agency to bill the primary. He told me that he would be resubmitting to the secondary. He never did. The claims were paid by the primary 5/09 and never sent to secondary. I submitted the EOBs to the secondary 12/09 and they denied, because of filing limits. It was after a year since the date of service. I want to appeal, but I don't know what my reason would be. A employee of the hospital's billing department, said that it is by their rules their responsibility to bill the insurance, and that they billed it incorrectly and once they recieved payment they never rebilled the secondary. She also said that usually you have a year from the date the Primary paid to get claims to the secondary. I don't know how much of this is true... Please Help! I can't afford to get legal advice...I just had to pay $940 to keep from getting sued for these medical bills

 

[ecmst12]

The secondary insurance was billed originally within the timely filing limit - it just took a while for you to submit the primary EOB. But the first date of submission is the only one that counts.

 

[blunamy]

Basis of Appeal

So when I appeal these claims what reason for appeal should I use?

 

[ecmst12]

The reason is that the claims were originally filed within the time limit. Their system should have a record of that.