medical billing

[emin1952]

What is the name of your state?Illinois How much time does a doctor or hospital have to bill you in a timely manner.
Am I responsible for services over a year ago that I have not been billed for?
They have summitted to the insurance company but was denied due to past timely processing. I still have not recieved a bill.

 

[somarco]

Generally speaking, yes (you are responsible) . . . but it depends on the contract your provider has with your managed care company.

 

[ablessin]

file limit

If I was you, I would contact your insurance carrier and ask them. SOME policies will say "no" the insured is not liable if the facility does not file within a timely manner.
After all, it's probably not your fault the facility didn't bill in time.
I say probably - because the only way would have been if you didn't provide the correct insurance billing info at the time of service.

Otherwise, poor billing practices like that are beyond the patient's control.

Let me tell you something...... say your facility charges
$95.00 for an office visit.
Your insurance carrier might allow $60 for the visit....... so, if you have a $10 copay, you pay that - the insurance pays $50.00 - the other $35.00 left over is called a contractual adjustment.
They make their money on self pay patients, because you get the whole bill, where with insurance, they have to accept the negotiated fee.
Unless the office has a self pay sliding fee scale, but that's not the point here.

Call your insurance and ask.

Good luck

 

[ablessin]

forgot something

How long they have to file depends on the carrier and what the negotiated time limit IS.

In NYS they vary - If we bill Blue Choice, we have 90 days.
Some carriers are 180 days, some are longer.
It depends.