Medical bill issue, some questions...

[fernweh]

I got a bill in the mail today for medical services I received in January 2015.  I paid co-pays for all my visits/follow up plus a fairly large bill a couple months after the fact.  The medical provider listed is not a Doctor that I saw at all/have never heard of this person.  I looked up the doctors working in the  department I was seen in (Dermatology) and there is no doctor by that name even listed.


I'm going to call on Monday and see if I can find out what is going on but in the mean time... It has been 13 months, how long can they keep sending bills for?  This is the first one that I have gotten in a year (not 2nd/3rd notice or anything).  Does it seem odd that they list a provider that I never saw or was in contact with in anyway?

[greenlight]

I've seen it before when a facility will bill under a different provider's name. I would call your insurance company first and ask them about the visit. The bill should list a date of service. Then you can do a 3 way call with the Doctor's office and get it straightened out without any confusion.

[daisyn]

Could it have been a dr that read an x-Ray or something like that? Definitely call of course.

It could've taken that long because of insurance processing issues. Maybe it was coded wrong and had to be recoded or something. Check with your insurance too. My son had surgery and the facility did not properly submit in time to my insurance company so the facility had to write off the whole cost including the $1800 or so that I was supposed to have paid. Insurance company have agreements like this in place a lot of times.

[JayhawkGirl]

I have had a couple trickle through way after the fact. They probably closed out 2015 accounts and found some they never got sent to insurance.

[Jalapeñomel]

I've had a bill come in 3 years later? It was something ridiculous.

If there is any inkling of doubt call and escalate until you get the answer you're looking for. I've had bills where offices have tried to charge me for services I never received, and it would've gone unnoticed had I not looked over everything with a fine tooth comb. It's really shady stuff.

[fernweh]

Feb 13, 2016 21:37:00 GMT -5 daisyn said:

Could it have been a dr that read an x-Ray or something like that? Definitely call of course.

It could've taken that long because of insurance processing issues. Maybe it was coded wrong and had to be recoded or something. Check with your insurance too. My son had surgery and the facility did not properly submit in time to my insurance company so the facility had to write off the whole cost including the $1800 or so that I was supposed to have paid. Insurance company have agreements like this in place a lot of times.

I don't think so, I had no x-rays taken.  I had several cysts removed from my scalp. The same doctor gave the shots to numb the area and removed the cysts, removed stitches at follow-up appts.  He is literally the only person I dealt with through out the whole process.  They did send them out for testing to make sure they weren't cancerous but I already paid a bill for laboratory fees. I have no idea.  I guess I will have to see when I call.

[cinderbella]

When was it submitted to insurance? Most timely filing is 12 months - check with your SPD and when it was processed.

Also, wine. So hopefully this hasn't been covered. But let me know if you have questions - I come from BCBS and appeals so I might be able to help. After wine.

[5thofjuly]

Feb 13, 2016 21:46:51 GMT -5 fernweh said:

Feb 13, 2016 21:37:00 GMT -5 daisyn said:

Could it have been a dr that read an x-Ray or something like that? Definitely call of course.

It could've taken that long because of insurance processing issues. Maybe it was coded wrong and had to be recoded or something. Check with your insurance too. My son had surgery and the facility did not properly submit in time to my insurance company so the facility had to write off the whole cost including the $1800 or so that I was supposed to have paid. Insurance company have agreements like this in place a lot of times.

I don't think so, I had no x-rays taken.  I had several cysts removed from my scalp. The same doctor gave the shots to numb the area and removed the cysts, removed stitches at follow-up appts.  He is literally the only person I dealt with through out the whole process.  They did send them out for testing to make sure they weren't cancerous but I already paid a bill for laboratory fees. I have no idea.  I guess I will have to see when I call.

I wonder if it's the doctor who interpreted the lab results.

[thatgirl2478]

According to my insurance company, they can review claims for up to 5 FIVE!! years.

We just got an adjusted bill from services my DD2 received in Nov 2014...

[kirra]

I had the wonderful experience of sorting out bills from three years before- the office forgot to file them, and didn't remember until they pulled up my account when I became a patient again.

[kirra]

They usually bill the dr separately from the lab bill. So I'd pay my doctor's copay, the procedure cost, the lab costs, and the dr at the lab. I wouldn't be surprised if this is what you're dealing with, but definitely call.

[mich1]

Feb 13, 2016 21:46:51 GMT -5 fernweh said:

Feb 13, 2016 21:37:00 GMT -5 daisyn said:

Could it have been a dr that read an x-Ray or something like that? Definitely call of course.

It could've taken that long because of insurance processing issues. Maybe it was coded wrong and had to be recoded or something. Check with your insurance too. My son had surgery and the facility did not properly submit in time to my insurance company so the facility had to write off the whole cost including the $1800 or so that I was supposed to have paid. Insurance company have agreements like this in place a lot of times.

I don't think so, I had no x-rays taken.  I had several cysts removed from my scalp. The same doctor gave the shots to numb the area and removed the cysts, removed stitches at follow-up appts.  He is literally the only person I dealt with through out the whole process.  They did send them out for testing to make sure they weren't cancerous but I already paid a bill for laboratory fees. I have no idea.  I guess I will have to see when I call.

There should be a pathologist bill along with the lab fees.  Labs process the tissue, pathologists read the slides and provide the info back to your doctor.   You likely would not see this name.

It is not uncommon.  I got a bill from a radiologist I had never seen.  X-rays were taken (and read) in my orthopod'so office, but all X-rays were sent to the hospital and read by the radiologist too.

[dirtyred]

Feb 13, 2016 21:46:51 GMT -5 fernweh said:

Feb 13, 2016 21:37:00 GMT -5 daisyn said:

Could it have been a dr that read an x-Ray or something like that? Definitely call of course.

It could've taken that long because of insurance processing issues. Maybe it was coded wrong and had to be recoded or something. Check with your insurance too. My son had surgery and the facility did not properly submit in time to my insurance company so the facility had to write off the whole cost including the $1800 or so that I was supposed to have paid. Insurance company have agreements like this in place a lot of times.

I don't think so, I had no x-rays taken.  I had several cysts removed from my scalp. The same doctor gave the shots to numb the area and removed the cysts, removed stitches at follow-up appts.  He is literally the only person I dealt with through out the whole process.  They did send them out for testing to make sure they weren't cancerous but I already paid a bill for laboratory fees. I have no idea.  I guess I will have to see when I call.

It's probably for the pathologist who looked at your specimens.

[brewco]

Pull your Explanation of Benefits for the procedure and see if what you paid adds up to what your EOB said you could owe. Sometimes the insurance company does a re-adjustment on your claim for some reason and you get billed whatever should have been towards your co-insurance, deductible or co-pay. I agree with others that it could be the bill for the pathologist who read your slides. The lab bill would be completely separate from the facility bill unless your doctor did everything in office (including reading the slides).