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Medical Bill on CR...ins will pay


mommabear
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Husband went to ER 8/2004. Forgot his insurance card. Long time has passed, forgot all about it until we started credit repair. It's being reported by a CA (PARC)

I plan on calling the OC tomorrow to tell them insurance was to cover this and give them ins. info. How do I go about a PFD on this? Insurance is still the same.

Thanks!

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If the date of service is way back in 2004, you need to contact your insurance company first and see if they will pay a claim that old. There is a timely filing limit for claims which varies between companies and policy type.

If the time limit has passed then you need to contact the provider to see if you can work something out.

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If the date of service is way back in 2004...

If the time limit has passed then you need to contact the provider to see if you can work something out.

Actually if the provider failed to submit a claim in a timely manner or the claim was returned to the provider and needed additional information and the provider never followed up, then in most states the provider has forfeited any claims to unpaid fees/charges. The original poster will need to contact the insurance company to review the claims history for the time period in which the service was provided (they will provide this information even if you are are no longer covered by the plan/company).

Assuming that the OP was not responsible for co-pays, deductibles, or other non-covered fees, if the claim was filed and never paid by the insurance company then the dispute is between the provider and insurer. If the claim was filed but returned or rejected by the insurance provider and the health care provider did not follow up/refile the claim in a timely manner, then the provider no longer has a right to pursue the debt. In this case, the OC will not likely discuss the matter as it has been sent to collections so the OP may be find it necessary to file a complaint with the Attorney General in the state in which the OP resides as well as the states board of insurance.

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ms6073...

That's all correct information however the OP indicates that the provider was never given the insurance information. (Unless I misunderstood)

"Husband went to ER 8/2004. Forgot his insurance card. Long time has passed, forgot all about it until we started credit repair. It's being reported by a CA (PARC)"

The provider can't bill the insurance if the patient never follows up and forwards the insurance information to them.

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Here's the story with all the details.

Up until July 2004, I carried insurance through my work. Quit working there the 15th of July. The way the ins. was set up, we were covered through the end of the month.

DH goes to the ER sometime in August. We had applied for state medical card, were approved, but hadn't got our card yet. Were covered from August on.

When we did get the card, it just wasn't dealt with.

Called the OC today. Told me that since is was almost 3 years ago, they couldn't pull it out of collections. Ok, so I call the CA. They feed me some line about how we are responsible for it and if ins. wants to reimburse us then great. Also said they won't delete. Told him to have a nice day and hung up the phone.

Call ins. company (public aid, whatever) and they said since it was awhile ago, they will send me a form to fill out with all the info and they will look over it and deal with it.

It's for a huge (sarcasm) amount. $429. Hopefully this will teach DH to take care of things before they become an issue.

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They feed me some line about how we are responsible for it and if ins. wants to reimburse us then great.

I went through this in 2002. And to this day it is still not resolved. The guy in the emergency room triage didn't change my information and they billed an old insurance. I was able to get mine sent back to the hospital from the CA 2 times. Both times I was told by the hospital that they couldn't re-bill it. That I would have to pay and get the ins to re-pay me. Total bull. My ins was trying to fight for me, but said they needed the bill to be sent from the hospital through whatever billing system they had in place at the time, and a copy of the bill from me was not going to get me a check payable to the hospital.

I was caught in a twisted cycle. This was also years ago and done by phone so i have no papertrail. To top it all off, when I did see the bill, there were charges for stuff like labs that were never performed.

Stay on it mommabear, as I would like to see someone like you win in a situation like this.

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