- April 23, 2024
- Posted by: legaleseblogger
- Category: Related News
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## Situation: Daughter’s Urgent Care Bill Dispute
Daughter went to an urgent care in 2023 for medical tests. The urgent care facility sent the tests to a lab, resulting in a bill of over $1k, received recently on 12/13/23. However, the family noticed that the lab had not applied their insurance, which at the time covered all expenses with no copay. They have since switched to a new insurance plan in 2024, which will likely have a significant copay for this outstanding invoice.
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## Disputing the Billing Error
When informed of their oversight, the lab attempted to retroactively apply the old insurance, only to be denied due to the daughter no longer being covered under that policy. Given that the error was on the part of the lab for failing to bill the insurance initially, the family is wondering if there is any recourse for disputing the charges.
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****** just grabbed a
>When told of their error, they tried applying the old insurance, but we’re denied since she is no longer covered with them.
Then they did something wrong. Insurance claims are based on the claim in-force on the date of service. You had insurance coverage on the date of service. They need to resubmit it with the correct (last year) date
The old insurance is obligated to cover that claim.
Whatever insurance you had at the time pays. They probably tried to bill it as if it happened recently because insurance often has clauses where claims must be submitted timely or else the provider simply has to eat the loss.
Thank you all! Will get on the phone with them and have them resubmit with the old insurance.
As others have said, it is on the health provider to bill the correct insurance. You are not responsible for their mistake. Tell them to file it with the correct insurance. That insurance will likely deny that based on untimely filing. This does not make you responsible. That is between the provider and the insurance to figure out.
Also, f private Healthcare. It’s all a scam.
Call your old insurance and let them know what this provider is trying to pull.
The claim is not that old. I had a set of surgical/post-op hospitalization claims take over six months to fully go through.
The provider must submit to the previous carrier and that carrier is responsible for payment.
She was covered at the time of the claim. The provider was in-network at the time of the claim. Both the carrier and provider are contractually obligated to honor that.
You are only obligated to pay what you would have if the claim had been filed immediately.
They have to submit it to old insurance
I had something similar years and years ago and what actually happened was place billed insurance with wrong codes initially and insurance rejected it. Place failed to rebill insurance within 1 year and the contract between insurance and place said they had to bill within 1 year so, obviously damn with no moral and greed tried to stick me with it even though it was their fault. Insurance enlightened me that is what happened that I wasn’t responsible and why insurance would not pay it now or ever because it places fault under insurance contract with place. Went back to place and after much back and forth they relented and had to eat it but it wasn’t easy to get there at least a dozen calls and back and forth.
It goes by what insurance you had on the date of service not what you currently have now.
If you had a different insurance when the procedure was done – then it is THAT insurance that needs to pay.
This is a critical component of insurance. You only have insurance if you have it AT THE TIME.
Otherwise people would just buy really really good insurance as soon as the bill comes – there would be little reason to carry health insurance *until* you needed it, because what you are suggesting would mean you can just buy it after you have your dental/vision/healthcare taken care of and avoid paying premiums in the other months of the year.
They need to resubmit it to the insurance carrier at the time of service.
Your new insurance wouldn’t pay on the claim anyways. It predates their contract with you. The lab needs to send it to your old insurance.
Throw all of the medical bills in the trash.
Keep repeating this process until the bills are much smaller, or just stop coming all together.