When does the statute of limitations start for medical services? Does it start right after the procedure is done or after the first bill goes out or after it gets to a CA?
Of course, but repeat visits may be considered revolving. Only thing is that the invoice numbers change with each visit, unlike ordinary revolving/open accounts. But that should not be a stipulation of the account type. Just thinking out loud :O)
If I may ask, why is it going to a CA? Was the procedure covered under issurance? Did the medical care provider bill the claim to the insurance provider in a timely basis (within 90-days)? As long as this was a covered medical expense and the claim was not filed in a timely basis, then the health care provider may well of violated its agreement with the insurance provider and really does not have a right to send the account to collections. I know, I bet the health care providers website/literature says the debt becomes the patients responsibility if not paid in XX amount of days/months. Obviously it is more cost effective to send the account to a CA and not tell the consumer/patient that they should be eating the debt since they screwed up! Of course if the health care provider can prove that a claim was filed in a timley basis and the insurance company denied the claim for some reason (wrong name, member number, goup number on the claim, etc.) then it is time to light a fire under the insurance companioes back side! Michael
Re: Re: Medical Staute of Limitations... If the ins co say they denied the claim /bc they sent a request for addtl info to the patient but got no response (b/c the patient did nto get the form), then how do we get this fire started?
Re: Re: Medical Staute of Limitations... I learned this the hard way a couple of years ago - if you go to the doctor or hospital, regardless, we the patient should always follow up as more often than not, we end up doing the other parties job to ensure that the claim gets paid! Obviously if the insurance provider has a record that a claim was filed in a timely basis but did not pay on the claim because for what ever reason they lacked sufficient information from the insured, then they should have followed up and it is now time to start shaking branches in HR and at the insurance provider. So in answer to your question, I would think that if this health care insurance is provided by the company for which you work, then in addition to calling the insurance claims department, you should also contact the person who is responsible for dealing with the insurance company in the human resources department at the company that provides the insurance. If you pay for this insurance directly, then you are the HR person and you need to contact them ASAP. You or the company that provides the health care insurance pays a healthy premium for that insurance and they are obligatted to provide service and coverage within the provisions of the agreement for the coverage. It is time to make sure that the insurance company is held to this agreement. If the medical collection agency (MCA) is reputable, you should be able to have an intelligent conversation with them stating that this should have been covered by your insurance provider. The MCA will need to get a copy of the original claim that indicates it was filed/denied in a timely basis. At the same time, you need to start your own inquiry with the inurance provider, explaining to them that you are beeing hounded by a MCA for a claim that was filed but apparently never paid. Unless the group/policy numbers have changed since the claim, they should be able to research this and expedite the payment of the claim once the required information is provided. You could also persue the fact that since the insurance company failed to meet their obligations, they should demand that the health care provider recall the debt from the CA and all derogatory information that may have been reported be deleted. Michael
