Author Topic: What is time limit for sending a patient a bill?  (Read 3939 times)

Michele

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What is time limit for sending a patient a bill?
« on: March 12, 2008, 06:07:50 AM »
Question

I have 2 questions.
1) We have a few accounts in our office that are very old and I need to know what the time limit is for sending a Patient a bill for services and once billed how many bills should be sent before collections. (oops 2 in 1)
2) My doctor does not participate with any insurances With the new statutes for HMO's they state that we are not to balance bill a HMO member but I read the statute and it does not state this for non-par providers. The only wording I have seen so far is for par-providers.
Please help I'm tired of getting yelled at by Aetna…..
Karen H

Answer
Hi Karen,
When we do patient billing we like to use a 3 bill process. The first bill we send is a detailed explanation of the charges, and what they are being billed for. The 2nd bill is a friendly reminder (if we haven't heard anything after the first bill) and then if we still don't hear anything, we send a final notice stating that if we don't hear from them in 10 days they are being sent to collections.
That process works fairly well. If a person has an ongoing bill, or pays a portion of the 1st or 2nd bill, then we just continue to bill without any mention of collections.

As far as how old a patient balance can be, the Statute of Limitations on debt depends on the type of debt and your State's civil debt collection codes. Generally, unsecured debt expires 3 to 6 years after the last missed payment or the consumer's last activity on the account. But I find that if you have a patient balance that is over 2 years old you have very little chance of collecting on it. Another factor is, was the patient being billed regularly the entire time. Most patients complain if they were not billed in a timely manner, or regularly, that it's not fair to bill them so late. We have a method that we tried once on a provider's accounts that were in collections that worked quite well. The collection agency we were using at the time wasn't able to collect on any of the accounts. (We switched agencies!) So we sent out letters telling the patients that if they paid off their accounts within 2 weeks, we would discount their balance 50%. We collected on about 65% of the accounts, which from a collection standpoint that is awesome.

As for your 2nd question (or should I say 3rd) I don't see why Aetna is yelling at you. As a non-par provider you do not have to follow their guidelines. You have no contract with them. You have chosen not to par with them so they cannot dictate what you charge the patient. The patient can choose not to go to you since you are not par, but Aetna cannot tell you what to bill the patient. Why are you calling Aetna? To check status? We bill for a provider in Florida who doesn't par and the only problem we run into is that they are constantly denying claims for notes and authorization. Even though he doesn't par, if he wants the patient to get reimbursed he has to send in the notes and request authorization. I would just remind Aetna that you do not par with them.
Hope that is helpful.
Thanks
Michele

Question
1) We have a few accounts in our office that are very old and I need to know what the time limit is for sending a Patient a bill for services and once billed how many bills should be sent before collections. (oops 2 in 1)

On this question here you answered below about the 3-6 years unsecured debts. What my problem is exactly is we have some accounts with charges from 2001, 2002 & 2003 where the last activity or correspondence was not beyond the year of 2003. I understand that there is no way we are going to get paid for these but is it legal to bill them this far out and/or send them to collections because they were never paid. They were originally billed to the patient or insurance back in the corresponding years and should have been sent to collections but were not.

Answer
Hi Karen,
The question on sending old bills to collections is really a legal question where the answers may vary state to state. Your collection agency should have a much better answer for you than we could give you. I would definitely call a collection agency and see what your alternatives are.
Alice
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