The laws vary state to state so you need to check your state laws. However, if the provider is in network with the insurance carrier then it is against his contract to bill the patient if the claims were denied for timely filing. I know I would be a very unhappy patient if I got a bill because my doctor's office didn't file the claim in time. The dr needs to consider that before making all of his patients pay (literally) for his billers negligence.Michele
I will have to get back to him as he was the one that was asking me if we could still bill these patients. I will tell him that we have to check the laws in Pennsylvania. Since he is aksing me I presume he wants to bill the patients (they probably for the most part are no longer current patients, so he is trying to recover what he can), but he was not sure if we could or not. Do you know where I can go to check on the laws for him or should I leave it up to him to research and decide as he would ultimately be the one responsible correct?
My question was not about the laws with timely fiing with the carriers. Their previous biller screwed up and did not get them in. I have tried to still submit and ask for exceptions etc. But my question was what is the laws (where do I find them) on sending bills to patients for these? When is it too late to send the bill as patient responsibility to them? And I see that some are saying if we are past timely filing with the carrier and provider is in network then it is against the contract to bill the patient?
A couple of days ago, we got a call from a very angry man. He was seen in 2001. He wants to refinance his home. His loan is being denied. He has an entry on his credit report about our bill. he says he was injured at work. I called and listened to 15 minutes of vile and foul language with threats of lawsuits. I explained that1. There is no documentation in the chart that he was injured at work. 2. There is no documentation recorded with the State that he was injured at work. 3. If he was injured at work, he never called us when he was being billed. He never inforrmed the collection agency via their letters and calls that he was injured at work. 4. I spoke with his employer. He never reported the injury, hence no report.The man accuses us of screwing things up and says this is all our fault. The State office and his lawyer called yesterday. The lawyer says he will sue me if we dont remove his account from collections. The state ordered me to remove his account from collections. I asked if they have a first report of injury on file as per FS 440-13 and FAC 69L-7.602. They dont. AT 4pm, the insurance company calls, they were just provided with a First Report of Injury. They asked me to fax them a claim and they would pay it. The lawyer, patient, and State all accused me of malfeasance. BUT, the bottom line is the patient was at fault. He never reported the injury, which caused the employer not to fil a eport causing the insurance not able to process any claims. His lawyer backed off when I threatened to countersue. Welcome to the wonderful world of medical billing.