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Just been billed 2.5 years after service

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Nasawoman

Guest
We had a child on Feb 17, 1999 and used our BC/BS Federal insurance through our preferred-provider pediatrician and local preferred-provider hospital. The child had some complications and additional testing was ordered by the pediatrician. The hospital and doctors billed BC/BS and by April 1,1999 and all billed charges were paid promptly.

In August 2001 (2.5 years after the child was born), we received a call (and subsequent bill) from a company that had evidently performed one of the additional tests. They stated that they had not been paid and that they had made previous attempts to send a bill, but had the wrong address (We had never moved nor provided an incorrect address to the hospital). We submitted the bill to our insurance company, but it was rejected because it was greater than two years after the date of service. We notified the company of the insurance company's decision. They are insisting that the bill be paid, or they will take further action to collect. (Had the bill been submitted in time, BC/BS would have paid the charges in full).

Our main question is: Are we under any obligation to pay these charges? (Since the billing was done so long after the date of service?)

What is to prevent someone from sending a bill, say 10 years from now? How can we be held responsible for knowing what medical tests have been ordered and from whom so we can track whether they have sent a timely bill? We're not in the medical profession nor mind-readers, we didn't even know we should have asked for a bill.

We have always paid our bills on time and in full. Also, this is the ONLY charge that we have ever gotten, in 10 years, that was not submitted directly to BC/BS. They don't even have a mechanism whereby we could submit charges.
 


ALawyer

Senior Member
This is a shame, and I'd fight it and refuse to pay.

But please recognize legally you may owe the money.

There are statutes of limitation in every state that pertain to debts owed. Many are 3 - 6 years. Check your state's and if it is only 2 years you are okay -- if sued you'd raise the statute of limitations as a bar to their action in your response.

If not you have a more difficult case -- you'd argue the provider agreed to take the assignment and would have been paid but for its failure to bill you or the company within the appropriate period. Any health care provider must know that there is a short window to submit claims.

The danger is the possible threat to your credit. My guess is the matter has been turned over to a collection agency and they don't care as they are paid on the amount they collect, and some are brutal. If you have a lawyer who writes them a letter denying any obligation to pay then they can't harass you any more.
 

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