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  1. #1
    Join Date
    Feb 2005

    what is the statute of limitations on Medical Billing


    Here is the scenario:
    My duaghter was born on 10/26/03, and my wife had an epidural. She had insurance coverage through her work, and was olso covered on my policy through my employer. the anesthesiologists billed her insurance company, recived partial payment and attempted to bill mine, but sent it to the wrong address, even though the correct card/info was on file.
    Fast forward to 2/16/05, I had never recieved a bill or an EOB for this, I answered all their questions and gave them the info they requested again. My company had changed insureance companies in the meantime, but the old info was still available., now here it is October, I have yet to recieve an EOB from the insurance company and have learned that the company supposedly severed the old insurance company from any responsibility as of 12/31/04!?!
    My question is: How long does a company have to bill you for medical procedures in michigan, it was over 2 years before I saw a bill, and if the statute is longer than two years, how could the company I work and the old insurance company deny claims still inside that statute?
    Any help would be appreciated.

  2. #2
    Join Date
    Feb 2005
    New York
    Each carrier carries their own file limit guidelines (How long you get to file)

    Some are 90 days, some are 2 years, and everything in between.

    When there are 2 policies, you get usually 60 or 90 days to mail the claim to the 2nd carrier with the EOB from the primary payer.

    If the claim is lost in the mail, misrouted - or whatever the carrier is telling you - there is a problem.

    See, the thing is - you probably signed a piece of paper at the hospital guaranteing payment to the hospital for any and all services rendered.

    This puts you responsible for the bill. The hospital send the claim, but ultimately it is the patient's bill.
    I see this all of the time.

  3. #3
    Join Date
    Feb 2005
    The problem is my insurance carrier never even acknowledged the bill, and I was completely unaware of the balance until February of 05, well more than 2 years after service.
    Can an insurance company simply ignore a bill until its forced down the patients throats? I realize they make you sign "the paper" but can they bill me more than 2 years later? I have NEVER recieved an EOB for this, not even one stating that my coverage had expired.
    On the providers bill it clearly states that they did not bill me personally, and they never attempted to contact me until Febrary of this year.
    I appreciate the response, I just find it hard to believe this can happen. If I'm forced to pay this, which should have been covered by my insurance, what bodies can you report insurance malpractice to? Is this something a lawyer could make go away fairly easily, I'd rather pay a lawyer a couple bucks than let the insurance company get away with this, and even the service provider, its not my fault they left the bill lay around for literally years...it would have been paid promptly as all the other bills were, had they contacted me sooner.
    thanks again,

  4. #4
    Join Date
    Feb 2005
    New York
    There are often problems when a secondary - - I am surprised that the billing office waited so long.

    Often times, (this is a professional courtesy at my office) if a bill "sits" for a given time (usually 6+ months) we adjust it . . .
    It is unfair to slam the patient with a bill - especially 2 years after the service.

    Now, keep in mind that is our practice in our office, however I know that other offices follow similar procedure. It is not a law, but a courtesy.

    Have you discussed the bill with the rendering physician?

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