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[math2990]

I'm in Tennessee.

I have a son that has a medical condition requiring brain surgery at a children's hospital periodically. He is 11 and has had 15 or so surgeries since birth.

There is one doctor group that services this hospital that sometimes files the claims with the insurance and sometimes they don't. Because I don't make appointments with these doctors, I have no idea of knowing who hasn't filed their insurance claims yet. They will wait until after the time for filing a claim with my insurance and notify me that I owe them for the entire bill.

What is the law here?

Thanks,
math2990

 

[ALawyer]

Absent anything unique in your state's law, the doctor provides the services and you owe him the fee you agreed upon, or if no fee was agreed upon, you owe a reasonable fee as payment for services. The insurance company reimburses you, based on the terms of the plan, UNLESS there is another agreement between the doctor and the plan, or you make another agreement with the doctor, or your plan specifies otherwise .