My question involves collection proceedings in the State of: MI
I had a minor outpatient procedure 3/2017 (I walked in and out in an hour, performed in the office setting). The physician was in-network and apparently used a mobile anesthesia group that was not in-network. I also had a secondary insurance, which apparently the anesthesia group does not participate in. I did speak with the doctor's office prior to the procedure asking what I would owe and was told it was all covered between the 2 insurances.
I received a bill 8/2018 from the anesthesia group stating I owed them $908 for the services. I did talk to them and they had excuse after excuse for not sending me a bill prior and requested that I speak with the insurance company to ask that they consider them in-network. I explained to them that even I knew insurances after a year generally do not accept claims or allow appeals, but they insisted that they had several clients that have done this. I did get a letter on 9/17/18 that indeed, it is way too late. So now because of negligence on all parties, they have sent the bill to collections after 1 billing cycle!
I have contacted the doctor's office twice with no return call and I plan on tomorrow going there to speak to them in person. I am willing to pay a portion but do not believe I should be responsible for anything higher than my deductible, which I think is more than fair ($250). Is this legal, what they are doing, by waiting to notify clients and they can no longer appeal to the insurance company?
Thank you so much for listening to me...
I had a minor outpatient procedure 3/2017 (I walked in and out in an hour, performed in the office setting). The physician was in-network and apparently used a mobile anesthesia group that was not in-network. I also had a secondary insurance, which apparently the anesthesia group does not participate in. I did speak with the doctor's office prior to the procedure asking what I would owe and was told it was all covered between the 2 insurances.
I received a bill 8/2018 from the anesthesia group stating I owed them $908 for the services. I did talk to them and they had excuse after excuse for not sending me a bill prior and requested that I speak with the insurance company to ask that they consider them in-network. I explained to them that even I knew insurances after a year generally do not accept claims or allow appeals, but they insisted that they had several clients that have done this. I did get a letter on 9/17/18 that indeed, it is way too late. So now because of negligence on all parties, they have sent the bill to collections after 1 billing cycle!
I have contacted the doctor's office twice with no return call and I plan on tomorrow going there to speak to them in person. I am willing to pay a portion but do not believe I should be responsible for anything higher than my deductible, which I think is more than fair ($250). Is this legal, what they are doing, by waiting to notify clients and they can no longer appeal to the insurance company?
Thank you so much for listening to me...
Medical Billing
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