What are my options when my provider sends me a bill without submitting a claim with my med insurance, and is ignoring my repeated requests to submit the claim and send me a revised bill post-settlement? How do I prove that I do not owe the billed amount, and I do not owe them anything until they claim it through my insurance first?
Unfortunately, I did encounter something very similar with a previous provider - and I naively decided to wait and watch when their “billing desk” was busy ignoring my requests to submit the claim first - just to get to the day when they sent it to collections. Dealing with collections is another nightmare, and while it went in my favor at that time, I promptly left that provider and switched to another.
So I want to be cautious here this time, because although the “billing desk” of my provider might be a bunch of inefficient a-holes, I don’t want to deal with collections again.
Would welcome any insights ! Thanks !
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Note - this is in the USA.
You are worried about a medical situation ruining you financially, we know that you live in the USA, but the rules in the sidebar want you to edit the title to say [USA].
One of the major problems with collections, is that there aren’t any checks and balances. Whoever can just get a collection agency to go after basically anyone. Once it gets to collections, it’s often on you to try to prove that you don’t need to pay the bill, and not them needing to prove that you do need to pay the bill.
Does your medical insurance advocate on your behalf, can you send them the bill yourself for them to deal with?
Thanks for pointing it out. Edited the title.
Does your medical insurance advocate on your behalf, can you send them the bill yourself for them to deal with?
They generally do. In fact the previous incident I mentioned about in my post - the provider said they sent the claim to my insurance, while in reality they did not. My insurance stepped in at that time (because the bill explicitly mentioned “claimed to XYZ insurance”, and that was obviously a lie) - and they sorted it out with the provider (basically the provider admitting that some intern screwed it up and they had to actually submit the claim). I still left that provider.
This time it’s different - because the provider has not yet submitted the claim and are is not hiding it either. They are just ignoring my requests to first claim then bill.
Not sure if my insurance has anything to do here.
I am not an American, but you may be able to submit it to your insurance yourself. Where I live, teeth are joking called “luxury bones” because dental isn’t covered for everyone by the government. Some dentists/orthodontists just don’t submit things to insurance, and we need to do it ourselves, though the vast majority of the offices do submit, because people will avoid those that don’t if they can.
