Anyone know the statue of

[bamamomto4]

limitations on medical billing?

I got a dental bill today for $134.20...I called and asked when this was from,seeing as we haven't seen this dentist in THREE years....She says from 10.25.01....Isn't there a statue of limitations on medical billing? I've search the net but can't really find anything....Anyone know?

TIA!

[guest2]

I have no idea Tammy but I do think it's ridiculous for them to have "delayed" billing you for this long.

[Kimmomo3]

I don't think there is a law but i thers were it would be a state thing. But I do know insurance won't pay a claim if it is submitted like around 3 mo. after the service. I don't know if that is a law of some sort or just a policy. If you did have insurace at the time thay won't pay.

I had a hospital bill me personally because they submitted late and insurace would not pay. After I pointed it out they ate the charge.

I am a medical biller so I do know a (very)little bit on the subject.

I would look at consmuer laws, but I don't think they can bill from that far out. BUT did you know you had the service and hadn't paid the bill, or did you think insurance paid it? Just nosey.

[Sara Noel]

Here's the statute of limitations state to state. HTH
http://fair-debt-collection.com/statue-limitations.html

[bamamomto4]

When I called yesterday the lady said that was what was left over from what the Ins didn't pay. I paid my part when I went in,before they did anything to me!!!! I have the check made out and ready to mail but I just don't think I should have to pay this.

This was when I had my wisdom teeth out.


Thanks Sara--I'm checking that out now

[bamamomto4]

I'm a little confused.Would this be under the Open accounts..??


http://fair-debt-collection.com/SOL-by-State.html#1

[bamamomto4]

One more thing I should add....The lady told me bills were sent over the years to me,which I told her,I never got....and I never got one till yesterday.She said they were sent out computer generated..??!! Will that matter if they decide to take me to court if I don't pay this? WILL they take me to court over $134 ?? Edited to add.....The bill has the amount I owe $134 but has a 35% fee if I don't and it's turned over to an attorney....I guess I should have asked Will that collection agency take me to court?

I'm not one to try to get out of paying a bill,don't take me wrong. I just don't see where they can bill me 3 years after the visit.Even though she said bills were sent,I never received one.I paid my balance at the time of service.

[Kimmomo3]

Let me make sure I understand, I confuse easily

You had yor wisdom teeth pulled and it cost (for example) 2000.00. insurance covered 1000.00 you paid 1000.00 before the procedure was done and now they are coming at you with another 100.00 plus fees. Right?

If that is right I would ask them for your acct. history and an itemized bill, see if there are any mistakes and go from there.

The billing thing, did you move? If not I am not sure I would belive that story. Wouldn't they call you before they send a bill on to a collection agency?

sorry you are going through this junk.

[dz_blonde_girl]

After that long you need to dispute the bill and have them show when, where, why, how, and exactly what they think you owe.

The pharmacy here sent me a bill from over a year ago. They claimed that they had been sending me bills every month. NOT. I told them that I did not think I owed them anything and asked for an itemized bill with names, dates and prescription numbers. I never heard back from them.

[i.m.cheap]

That is weird to not get a bill for three years, and then "surprise!" one shows up in your mailbox. Had you moved during that time?

[bamamomto4]

When I got the bill it shows an amount owed of $134.20 .If I don't pay this amount by 12/31 they're sending the bill to an collection agency and the agency will charge me another 35% making it $180+

I called because I know I haven't seen that Dentist in years,and not sure why I was getting a bill.She tells me that this balance is what the Ins CO didn't pay. My Ins (at the time) covered 80/20 I had to pay the 20 before they did the surgery.She also said that my Ins Co didn't pay as much as she thought it would and that I have to pay the balance. I ask what the date was and she said 10/25/01...so I ask why they wait THREE years to send this.She goes on to say that bills were sent etc which I swear,I never received a bill till this one. I then ask wasn't there a statue of limitations on billing and she says no.I say I think there is and she tells me maybe I should consult an attorney.I say I think I will and she hangs up.

I have not moved since then and they have called several times wanting to set up an appt for the family cause it'd been so long since we'd been there. I never called back because we'd been seeing another dentist. They never called saying I owed this.
I think what happened was the Ins didn't pay it and they were going through files and this came up and they thought they'd bill me

The more I think of this,the madder I get. As I said before,My Ins paid 80/20 I PAID MY 20% that should be it!!!!!!!!!!!!!!! Wouldn't you think??!!

I have the check all ready to be mailed but I'm calling tomorrow and asking for an itemized bill as Kim suggested (thanks).

Please understand,I am in no way just trying to get out of paying this.I'm one that has always paid my bills on time and if I've gotten this 3 years ago,I'd paid it..no questions asked. But to bill me three years after the fact just really tees me off.

[dz_blonde_girl]

... and then only give you a month to cough it up? I'd be mad too. It probably should have gone to collections 2 years ago! (I mean if you really owed it)

I don't think they can charge you fees if you're disputing it.

[GinaBean]

I used to work in Managed Care (dealing with health insurance) at one of the big hospitals in Birmingham and processed Medicare claims at BCBS for a while.

Who was your insurance carrier at the time of service? I would call them and ask them for a copy of the EOB (explanation of benefits) if you do not already have a copy. If the dentist was a participating dentist, they may not be able to charge you for what the insurance didn't pay. When doctors and dentists sign up to participate with a certain insurance company (Blue Cross, United, etc) they are agreeing to a certain fee schedule that is set by the insurance company. They do this as a trade to be able to provide services for all of the insureds under that plan.

Wether you owe it or not is going to depend on your policy and if they dentist was an "in network provider". Also, sometimes the policy only pays 80% of what is reasonable and customary. That amount is based on the average of what providers in the area charge. If the dentist charges over the reasonable & customary amount, you may have to pay. You may have received some services not covered (certain anesthesia services, etc). You really need to call the insurance company and ask them before you pay the bill. If you still have a copy of what the insurance company sent you when they paid on this claim it would be helpful. If you don't, they should still be able to help you.

Hope that helps.

[bamamomto4]

Originally posted by GinaBean
I used to work in Managed Care (dealing with health insurance) at one of the big hospitals in Birmingham and processed Medicare claims at BCBS for a while.

Who was your insurance carrier at the time of service? I would call them and ask them for a copy of the EOB (explanation of benefits) if you do not already have a copy. If the dentist was a participating dentist, they may not be able to charge you for what the insurance didn't pay. When doctors and dentists sign up to participate with a certain insurance company (Blue Cross, United, etc) they are agreeing to a certain fee schedule that is set by the insurance company. They do this as a trade to be able to provide services for all of the insureds under that plan.

Wether you owe it or not is going to depend on your policy and if they dentist was an "in network provider". Also, sometimes the policy only pays 80% of what is reasonable and customary. That amount is based on the average of what providers in the area charge. If the dentist charges over the reasonable & customary amount, you may have to pay. You may have received some services not covered (certain anesthesia services, etc). You really need to call the insurance company and ask them before you pay the bill. If you still have a copy of what the insurance company sent you when they paid on this claim it would be helpful. If you don't, they should still be able to help you.

Hope that helps.

We had BCBS of Alabama through Wal-Mart Group health. Dh said BCBS only handled the billing part of the Ins and the actual Ins was WM Group Health.

The dentist was In network.

I called today and ask for a itemized bill..the lady said a audit was sent before and I told her the only thing I ever got from them was dated 12/7/04...She said she would send it.

I'll call BCBS tomorrow and see what they say.
This is really stressing me out right here at Christmas. We're having Christmas dinner here this year,so this is coming out of my food money

[bamamomto4]

well,wait a sec.....BCBS was health...I'm not sure if they handled the dental. I'll find out and call who ever it is I need to call tomorrow.See what I mean about stressing me out.I can't even remember who the dental was through from the past 14 years