Expert: Chris Ebert - 8/12/2009

Question
Hello,
I received a medical bill from last year. My insurance company paid the hospital 17 days after receiving the bill (which was within the same month I saw the Doctor). Now a year later I am receiving a statement from the hospital requesting I pay the difference. Is there a time limit the hospital can bill you?
Thanks!

Answer
Candice,

I am not sure of a specific time limit they have. Generally most businesses practice the 30-60 day rule.

What is more interesting is how to fight this.  It is not unusual to have a PPO or HMO plan where the carrier has a contract rate that calls for the care provider to accept that amount and nothing more, but the care provider violates the deal. By contract, and the patient is a third party beneficiary, the care provider cannot legally charge more. That is the problem. The medical practitioner is coming back after you for the difference.

I would:
a) Let your insurance company know.
b) Talk with the hospital know that they can not collect above the contract rates negotiated by your insurer.