Author Topic: Submitting claims late for billing and holding insured liable  (Read 1913 times)

Alice Scott

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Question
Good morning, 
What is the law in Michigan regarding hospitals summiting claims late for billing and holding the insured liable for services rendered after one year.
Charles

Answer
  A lot of this depends upon why the claims are being submitted late.  If the hospital didnít bill them on time, then if the hospital participates with the insurances being billed, then they cannot hold the insured liable.  If the hospital did bill them, but they were not processed, then the hospital needs to go after the insurance carrier, not the insured.  Most insurance carriers state that if a hospital is participating, it is the hospitals responsibility to file the claim properly.  The contract usually states that the patient or insured cannot be billed unless the claim is rejected due to a reason that is the direct responsibility of the patient/insured.

Good luck
Michele

 


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