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Wrongly billed after service

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#1
What is the name of your state?Virginia
A couple of years ago I fractured my wrist and needed physical therapy. I went to a local facility and received therapy for several months. Every time I went I paid a co-pay of $15.00. I thought that my co-pay should have been higher so I asked on at least 3 separate occasions if they were sure that the amount was correct and was assured that it was. About 8 months after I stopped going I got a bill for 750.00. After unsuccessful attempts to discuss this with someone at the facility I contacted my insurance company. They contacted the 3rd party billing company and was told that the bill was for additional co-pay, that the services I was getting required a larger co-pay than I had paid. Had the co-pay been more than they were charging me at the time I would have stopped going long before I did. I felt like the bill for additional co-pay was unjust and bordering on fraud so I ignored the bill and didn't hear from the company for nearly a year. I just received a letter from a collection agency wanting payment. I my mind i compare this to buying groceries every week for 6 months and then getting a bill from the store saying that they didn't charge me enough. Am I liable for this?
 


Zigner

Senior Member, Non-Attorney
#2
What is the name of your state?Virginia
A couple of years ago I fractured my wrist and needed physical therapy. I went to a local facility and received therapy for several months. Every time I went I paid a co-pay of $15.00. I thought that my co-pay should have been higher so I asked on at least 3 separate occasions if they were sure that the amount was correct and was assured that it was. About 8 months after I stopped going I got a bill for 750.00. After unsuccessful attempts to discuss this with someone at the facility I contacted my insurance company. They contacted the 3rd party billing company and was told that the bill was for additional co-pay, that the services I was getting required a larger co-pay than I had paid. Had the co-pay been more than they were charging me at the time I would have stopped going long before I did. I felt like the bill for additional co-pay was unjust and bordering on fraud so I ignored the bill and didn't hear from the company for nearly a year. I just received a letter from a collection agency wanting payment. I my mind i compare this to buying groceries every week for 6 months and then getting a bill from the store saying that they didn't charge me enough. Am I liable for this?
The statute of limitations for a matter such as this appears to be 5 years in your state, so yes, you are liable for it. You should review this with an attorney just to confirm (if it's worth it to you).
 
#3
It isn't up to your doctor's office to know your insurance co-pay. Filing insurance from you is a service provided by the doctor's office. Not a requirement. Even if they checked with the insurance carrier there is no guarantee they got it correct.

During these treatments you should have receiving an Explanation of Benefits (EOB) from your carrier either once a month or each time the paid a bill. Had you read the EOBs you would have seen that $15.00 wasn't cutting it.
 
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