Expert: Ray A Miller - 3/2/2011

Question
QUESTION: My wife just received several bills from the Southcoast Hospital Group for medical services that were performed fourteen months ago.  I seem to recall that in most busineses, if a bill for services is not submitted within 30 DAYS, that bill is not liable for payment.  In the case of my wife, her insurance account changed, and because the Southcoast Hospital Group apparently submitted the claim to a no longer valid account, the bills were not paid.  But regardless of this, shouldn't Southcoast either have gotten in touch with her immediately?  Isn't there any 'statute of limitations' on thi sort of thing?  The same out fit did the same thing to me, send ing me a bill a year later, and I just paid it, figuring it was just some sort of bureaucratic screwup, but here the SAME situation has occured!

ANSWER: Have you contacted your insurance company to see if the provider billed them and if they did, why were the bills not paid?  Most medical clients will bill the insurance company and wait for an answer from them before they bill the patient so, as I said, this can be cleared up with a call to the insurance company.  

If the medical provider had the insurance information and did not bill it, it may still not be too late.  Your wife was covered at the time and they are still on the claim.  If, by contract, it is too late to file and the provider had the information at the time of service, then the provider should write off the balance to timely filing.

I hope you have found this helpful and good luck.

---------- FOLLOW-UP ----------

QUESTION: Yes, and apparently they had my wife's birthdate wrong, and so apparently Southcoast Hospital Group and the insurance company just kept sending stuff back and forth between them, without notifying my wife that there might be an issue for correction, and NOW 14 MONTHS later, they send HER the bills, which is the FIRST time that she was notified!  Once again, isn't there some sort of time limit for these things?

Answer
Any statute of limitations beyond those set by your state would be in the contract between the insurance company and the provider.  Did you ask the insurance company if it is too late to bill?  If it is, the provider will most likely have to write it off to timely filing.  If not, the provider needs to correct the information and rebill the claim.  Thanks.