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Hospital Bill - No notice for 2.5 years

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stephjt

New member
On July 4, 2019, I suffered second and third degree burns on my hand. I spent half the day in the ER. I paid $800 to the hospital on September 5, 2019. I don't remember for certain if at the time of my payment, my insurance had not yet paid or if I thought they would pay more. I was just going to wait until the next bill arrived. But I didn't receive another bill and assumed all was good until April, 2022. I received an email from the hospital with an almost $3k bill attached. Then received a paper bill in the mail. My address, phone number and email address have remained the the same all these years so they made no attempt to bill me or contact me until April, 2022.

When I received their email in April, 2022, I went online to look at my account. I found my $800 payment but noticed it was not credited on the bill they sent me. I found that my insurance company had paid $13k in 2019. There was no other activity until April, 2022 and there is this entry - "04/08/22 - BCBS PAYOR CONTRACTUAL (MANUAL WRITE OFF) -1.22." The site had a chat feature so I used it and spoke with a rep named "Karen." I asked why am I receiving a bill almost 3 years after the date of service and why have I not received a bill since 2019? First, Karen told me I did not have an account balance. She said I must be misinterpreting the bill so I sent an image to her and then Karen told me she "located" the bill. She told me they had been contacting my insurance company and the insurance company had just recently made their final payment (the entry above for 1.22), so the remainder was the patient's responsibility and that was why I was now being contacted.

$1.22 does not seem like an insurance payment and in my experience, even if insurance is supposed to pay, I still receive regular bills. I contacted BCBS and they told me "no," they had paid the bill in 2019, nothing in 2022.

My objections to paying are: 1. The delay in contacting me. No contact in 2020, 2021, and first quarter of 2022. Then I'm informed I owe almost $3k. I don't believe a hospital should be able to do this. I've obligated myself to other expenses not knowing I had a hospital balance. 2. Upon inquiry, they first tell me I don't have a balance. Incidentally, when I log onto their website, there is an initial balance screen and it shows "0.00" balance. 3. My $800 payment is not listed on the bill so I'm not getting credit for that. So I wonder about other errors.

I feel like they originally accepted my and the insurance company's payment as full payment but for some reason in 2022, they reversed that decision. Maybe because recent law changes have made it harder for them to collect balance billing, so they are revisiting older accounts.

My main question is "Can they not send you a bill, email, or call you regarding a balance for 2.5 years, then suddenly start up again?"

I noticed I have a letter from Medical Revenue Service waiting in my mailbox today so it seems they have turned the account over to a collection agency. Should I speak to them? Only in writing?

Any other advise greatly appreciated. Thank you so much.
 


Taxing Matters

Overtaxed Member
Federal law does not mandate a time within a medical bill must be sent out. Few, if any, states have such a law either. So in at least most states sending the bill 2½ years later is not illegal. Nor does there have to be any particular requirements met before the providers turns it over to a collection agency. What really matters is whether the creditor/collector files a timely lawsuit to get a judgement for the debt. The law setting that time is known as a statute of limitation (SOL). The SOL varies from state to state, but for written contracts it's pretty typical for that period to be 4-6 years. Was this a preferred/in network provider for BCBS? If so, BCBS should be able to tell you what its share of the obligation is and how much the provider can actually come after you for. That will help you pin down what you truly may owe. Once you know that, then it's time to figure how to do deal with the amount owed.
 
The first thing to do is to send the Hospital billing department proof of your $800 payment and ask for a complete accounting. Once you have an accurate number, you can ask them for a payment plan. I know $3000 sounds like a lot to you - but in the scope of medical expenses, it is not, and hospital billing departments are accustomed to working with their patients. Some hospitals even have charity services to help those who are not in a position to pay their bills.
 

stephjt

New member
Yes, it is an in-network provider. The hospital is a non-profit. I am in Texas and I believe the SOL is 4 years.
Also, Texas has a "timely billing" law. It requires health care service providers to bill a patient no later than the first day of the 11th month after services were provided. Initially, they complied but if I had a balance I believe they had a duty to keep billing me, email or call me. After making a payment and not receiving a subsequent bill, it was logical for me to think my balance was paid. I may have even logged onto their website and seen a zero balance. It's been so long ago, I don't remember. I say it's possible because if I log on TODAY, it indicates a zero balance.
 

adjusterjack

Senior Member
Also, Texas has a "timely billing" law. It requires health care service providers to bill a patient no later than the first day of the 11th month after services were provided.
What is the penalty to the provider for not complying with the law?
 

Zigner

Senior Member, Non-Attorney
Both the Texas and Federal Surprise Billing acts appear to cover out-of-network providers.
 

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