If the provider exceeds timely filing limits with the insurance carrier the provider cannot bill the patient. The provider must have a participating contract with the insurance carrier also.
the bill becomes the law
I am currently a medical insurance biller in California. I bill for 2 doctors one of which is also works in a hospital. So essentially I bill for 3 doctors. But I make 13 dollars an hour at 40 hours a week. I have been doing it for 5 years.
no but you can sue them
Take it off your bankrupcy papers and pay the bill, at least the portion that the Insurance gave you. Check with your bankruptcy attorney, insurance agent or doctors office. Generally checks are sent direct to the doctor.
It becomes a pocket veto.
Tort Reform does not effect a doctors billing procedure in anyway. The patient is and always has been utimately responsible for payment of their own medical bills. It is a patients responsibility to either pay the bill or see to it that they are paid by whatever insurance instrument that may be pertinent.
Certainly if there is the contractual right to do so between the lab and the office.
Whatever the bill from the insurance company, hospital, and doctors plus co-payments and whatever else they prefer to add is your out of pocket limit
No, the hospital is generally NOT required to assign doctors, technicians, and labs that accept your insurance. This is a real oddity of the way the health care system works (or does not work). You can pay your co-pay for hospitalization and later still get a tremendous bill for lab tests, radiology, pharmacy, even anaesthiology, and when this happens you can struggle with claim forms for months trying to get partial payments from insurance.
You doctor is not obligated to send the bill to ANY insurance company unless the agreement between the carrier and the doctor requires it. More and more doctors are trying to relieve themselves of the paperwork nightmare of dealing with insurance companies. They will accept the negotiated rate but demad it at the time of service from the patient. It is then the problem for the patient to collect from the carrier.
AnswerPeople can do all kinds of things. Yes this happens all the time. I'm not sure why either, it would be much simpler and faster to go through insurance.
That is if the secondary does not have a clause in it that "they will not duplicate benefits" If so they will not always pay the difference. They will figure out the amount they would normally pay, subtract what the primary pays from that amount and pay the difference (which with mine is little to nothing and I end up paying the balance of the bill) Nothing really happens, one is the primary and the other is the secondary insurance for the patient. Primary insurance will pay up to 80% of allowed charges if the deductible is met, and the secondary insurance will pay the remaining 20% of the claim, again, if the deductible for the year has been met.