Question
Hi,
I saw a doctor over a year and a half ago and at the time, was under the assumption that the visit was being covered by my insurance. The office called me today to inform me that I owed them the full cost of the visit and that the insurance company denied the claim since I "wasn't covered because the insurance company had not received verification that I was a student". In fact, this is false. I was covered at the time.
I was told that this money is due in just a couple of days, or else they will put it in collections. I never received a bill or anything in writing from the office, nor have I ever received anything from the insurance company denying the claim. Meanwhile, I was covered for other unrelated medical expenses during the same time period. After calling my insurance company, Blue Cross Blue Shield, I came to find out that the office never submitted the claim in the first place. What can I do? I am worried that they will follow through with sending this to collections and that it will affect my credit.
Answer
Hi Sam!
I would call the Dr's office and tell them that you contacted your insurance company and was advised that they never sent the claim in. Ask for proof that they sent your claim in at that time and ask why you where not billed for a year and a half.
Perhaps also before calling the Dr's office call Blue Cross and ask how long a Dr has to resubmit a claim. I think it may be to late to even resubmit this claim however since it was already processed you may be able to.
I would then ask the Dr's office to resubmit the claim with information they requested........if unable to, tell the Dr's office that you feel you should not have to pay for their error. Tell them it is not fair to bill you now since you are not able to resubmit your claim due to untimely filing. Tell them this is unfair for you to pay for their mistake. If you have a copay perhaps offer to pay that but no more.
If they threaten to send you to the collection agency tell them you will dispute with them thus putting your account on hold and then contact the local News station.
These tactics usually work.
Good Luck!
Tricia
