Medical Billing Question

[daughtersrus]

Does anyone know if there is a time limit for a hospital/doctor to bill a patient?

My FIL just got a bill from U of Chicago for cancer treatment for my MIL for services from March 2005 with a co-pay of almost $500.00 Sadly, MIL passed away more than a year ago. At the time, my MIL was on Medicare and had a supplemental policy through FIL's former employer(he's retired).

This is the first bill for these services that they've received. The supplemental policy is saying that the bill is too old so they won't consider it.

He's trying to call U of Chicago but is getting the runaround.

I haven't seen the bill myself so I don't know when/if Medicare paid but it still seems like they should have sent it to the secondary policy before now.

Are there any laws or regulations that stipulate a time period for medical billing?

 

[cteddiesgirl]

I would flat out tell them that the person who received the services has been deceased for more than a year and if they had billed it when services were rendered, it would have been paid.

I simply wouldn't pay it. It's over 4 years old. It's their fault for not billing within a reasonable amount of time.


We went through this with my mother too. Months after she died, we received a bill for services rendered more than a month before she died. If they had billed in time, the insurance would have paid it. It was their tough luck for waiting so long to send the bill. The hospital finally decided to stop billing my dad for it a couple months after we received it.

 

[ols386]

Wow, that's too bad. Seems like there would be some law that states medical facilities cannot bill for services AFTER a certain point in time, after services were provided...that was 5 years ago. That's just not right. He may need to consult with an attorney to get this cleared-up. I think that's what I'd probably do, if the hospital and insurance companies are giving him the run-around. Bunch of greedy jerks.

Again, this just seems wrong to me.

 

[agnes!]

Not sure what jurisdiction you're in, but here vendors have 3 years to submit bills. The reason I know this?...

When my MIL died we received a bill those infamous 3 YEARS after her death - I seem to remember it had something to do with ambulance transfers & apparently had been kicking around between the ambulance service & the insurance company over something stupid like an incorrect code

I called up the ambulance company, talked to them - found out what the problem was.
I called up the insurance company, talked to them.
I got names and phone numbers of everybody I talked to.

When I last spoke to the insurance company, I gave that woman the name & number of the person at the ambulance company I spoke to. I told them I did not want to receive ANY MORE bills from them, that this was an issue between the insurance company & the ambulance company. This getting a bill THREE YEARS after the person died was very upsetting and this situation was not my DH's & my fault - if someone had only PICKED UP THE PHONE, the whole mess could have been avoided.

Thinking about it all these years later still irritates me.
agnes!

 

[ols386]

Not sure what jurisdiction you're in, but here vendors have 3 years to submit bills. The reason I know this?...

When my MIL died we received a bill those infamous 3 YEARS after her death - I seem to remember it had something to do with ambulance transfers & apparently had been kicking around between the ambulance service & the insurance company over something stupid like an incorrect code

I called up the ambulance company, talked to them - found out what the problem was.
I called up the insurance company, talked to them.
I got names and phone numbers of everybody I talked to.

When I last spoke to the insurance company, I gave that woman the name & number of the person at the ambulance company I spoke to. I told them I did not want to receive ANY MORE bills from them, that this was an issue between the insurance company & the ambulance company. This getting a bill THREE YEARS after the person died was very upsetting and this situation was not my DH's & my fault - if someone had only PICKED UP THE PHONE, the whole mess could have been avoided.

Thinking about it all these years later still irritates me.
agnes!

So sorry. Good for you for making those phone calls, getting names & numbers, to get it resolved.

 

[daughtersrus]

Thank you all for the replies. I offered to call U of Chicago for my FIL and talk to someone to see if we can get this figured out.

 

[ROIE01581]

The hospital has 18 months to bill medicare and medicare then will send the claim to the secondary.

But once the insurance has paid or denied then hospital has up to 7 or 10 years to collect on the claim. (depending on the collections laws for your state)

First you need to call medicare and find out if they paid and if they did, did they send the claim to secondary for the balance due.

Then you need to call the secondary and see how much they paid. YOur fil may be getting billed for the balance due from the insurance companies. Medicare usually only pays 80% of bill up to a max.

He should have gotten a notice from medicare telling him what they paid and something from the secondary as well.

I would take the bill and call the hospital billing and find out what was billed, what was paid and what the balance due is. Is it a deductible or copay.

But I would also tell them the mil has died and there are no funds or assets to pay for the balance.

Or ask for a settlement amount if you pay the balance in full. ( it should be at least 80% of the bill)

Or tell them you will make monthly payments of 50 or 100 a month.

(this is what I do all day. I do the billing for a hospital. )

 

[CajunDixie]

Thank you all for the replies. I offered to call U of Chicago for my FIL and talk to someone to see if we can get this figured out.

He'll have to be on the phone first so they can get his permission to talk to you per the privacy laws.

The hospital has 18 months to bill medicare and medicare then will send the claim to the secondary.

But once the insurance has paid or denied then hospital has up to 7 or 10 years to collect on the claim. (depending on the collections laws for your state)

First you need to call medicare and find out if they paid and if they did, did they send the claim to secondary for the balance due.

Then you need to call the secondary and see how much they paid. YOur fil may be getting billed for the balance due from the insurance companies. Medicare usually only pays 80% of bill up to a max.

He should have gotten a notice from medicare telling him what they paid and something from the secondary as well.

I would take the bill and call the hospital billing and find out what was billed, what was paid and what the balance due is. Is it a deductible or copay.

But I would also tell them the mil has died and there are no funds or assets to pay for the balance.
Or ask for a settlement amount if you pay the balance in full. ( it should be at least 80% of the bill)

Or tell them you will make monthly payments of 50 or 100 a month.

(this is what I do all day. I do the billing for a hospital. )

The red statement wouldn't work here. The surviving spouse is responsible and they would require proof that there are no assets and he has zero income.

The hospital needs to show him proof that they filed their original claim in a timely manner and IF it was denied they need to show why...did they make a mistake that caused the denial? The medicare explanation of benefits should show if they forwarded the claim onto the supplemental insurance company. And it should show if the patient had any responsibility amount.

Also make the hospita send him a itemized bill so he can see exactly what services and items he was charged for.

 

[rainy~daze]

when I worked for an insurance company, the hospitals/drs etc. had a certain amount of time to file a claim to us for processing, if after that timeframe we would deny as not filed in a timely manner.

the individual, however, could file it themselves for payment as there was no time limit for them to file themselves. so another option is asking the hospital for the bill/claim form, etc. so you can file to secondary yourself for payment.

 

[Buckalew11]

This happened to my mom 1 1/2 years after my dad died. She called and asked about it and the lady said they'd had a computer glitch and hundreds of bills went out that were wrong. She told mom not to pay it and they'd take care of it. maybe this happened to y'all too. I hope so!!

 

[MarkBarbieri]

I'd tell them that she's move on and didn't leave a forwarding address.

 

[WDWFAN9]

Something similar happened with my Mom, also from a doctor in Chicago. IF the doctor had submitted his bill to insurance and Medi-care it would have been completely covered, but it was rejected because it was filed two or three years late (I forget the exact details). Anyway the doctor's office started hassling my dad for the $1500 - fortunately our local hospital has a senior's advocacy office and they actually contacted the doctor on my dad's behalf and said that it was the doctor's responsibility to submit the claim in a timely manner and since he didn't my dad wasn't liable. Fortunately that worked, but it sure was upsetting to my dad.

 

[cteddiesgirl]

He'll have to be on the phone first so they can get his permission to talk to you per the privacy laws.



The red statement wouldn't work here. The surviving spouse is responsible and they would require proof that there are no assets and he has zero income.

The hospital needs to show him proof that they filed their original claim in a timely manner and IF it was denied they need to show why...did they make a mistake that caused the denial? The medicare explanation of benefits should show if they forwarded the claim onto the supplemental insurance company. And it should show if the patient had any responsibility amount.

Also make the hospita send him a itemized bill so he can see exactly what services and items he was charged for.

Not necessarily.

My dad was not responsible for any of my mom's hospital bills. She checked herself in and signed for herself. Because of this, my dad was not held responsible for her bills in this state. I don't know how other states work, but that's the way it is here.

 

[tasha99]

If this were in Oregon, it would work like this:

The bill is a claim on the estate. It is the personal representative's responsibility to look for claims (you can't just be passive--you have to contact people who you think might have a claim, and you have to publish a legal notice in the paper for 3 consecutive weeks). The claim, once submitted, would get in a line of "who get's paid first," and all claims would have to be paid before the estate could be closed. Doctors for the final illness get paid before previous doctors, estate administration lawyers get paid first of all (surprise surprise), etc.

Has the estate been probated? If so, I would give the lawyer who handled it a call. I have no idea how something like this is handled. My guess is that if the probate is over, I don't see the hospital suing over $500, but who knows.

 

[Mermaid02]

This thread is 3 years old and "Mike" bumped it up this morning- reported as spam and please, don't anyone click on his "link" !!

 

[Cheshire Figment]

I had an ambulance company send a bill more than a year after Judy died. My response to them was that (1) I had not signed anything, only Judy had, (2) the estate was closed, and (3) gave the cemetery address, including plot number, as her forwarding address and said to contact her directly. Never heard from them again.