Tuesday, March 2, 2010

Denied by BCBS 2 years after Service

Question
I just received in mail an explanation of benefits denying coverage was in place from services received 7/18/07.  BCBS says they were just billed 10/21 by the provider whom they are calling "out of network" only because no coverage existed.  My previous employer, I thought, was going to pay the July 07 premium for me even though I was let go 6/30.  That's another issue.  But how can they expect to deny the coverage 2 years and 4 months later.  I actually filed bankruptcy in 2008 and would have included these charges in the filing had I known about them.  What can I do now?  Do I have any recourse? Rights?


Answer
Hi Paul!



I would call the provider to see if they will waive the entire bill due to them taking 2 years to bill.  Explain that if they billed 2 years ago you could have fought it since your employer told you they would pay up until July 07.  Explain it is now to late to go back and fight your ex-employer.  So due to their mistake on not billing on time you feel you should not owe.



See if this works if not perhaps offer to pay your copay only.



Good Luck!

Tricia