Not billed to my insurance

by Dave
(Troy, Michigan USA)

My eye doctor billed my BCBS insurance and they payed $35.00 of a $240.00 bill. But I at the time had two policies with VSP one through my wife's company and one through my company. I called VSP and they told me that they didn't bill them through my wife's policy, and being that it's been a long time that they have no way of telling if they billed it though my VSP. I paid them a $30.00 balance at the time I picked up my glasses.

So my question is who is responsible for this bill I gave them all the insurance info and they never billed the right insurance. I did all I could do I can't run their business for them.I never received a bill until now over 4 1/2 years later from a collections company.

Thanks Dave

Reply from DebtCollectionAnswers.com:

Dave,

We don't have a clear, specific answer for you. We think there should be a "Truth In Medical Billing Act" that covers these kinds of scenarios, but since there isn't, these kinds of problems can be a real hassle to resolve.

However, we'll give you a couple of suggestions.

First, talk with VSP and ask them whether their contract with their participating providers require them to bill within a certain period of time. It probably does.

Second, go in person to the eye doctor's office and insist they show you their records proving that they billed the correct insurance and that it was denied. It's true they may try to hold you responsible if insurance doesn't pay, but if you had insurance that would have covered it, then they should have either billed it correctly or contacted you when there was a problem. (If they don't have those records, then what business would they have turning it over to a collection agency?)

Explain to the eye doctor that this is the first time you've heard of this in more than four years, and that unless they can provide proof that the insurance company was billed correctly and you were responsible, you want the bill erased.

Finally, you have the right under the FDCPA to dispute the bill with the collection agency. Do that in writing immediately, and send your letter by certified mail. You can simply tell them you don't believe you owe this bill. Keep a copy for your records.

We're not attorneys so you may want to get legal advice on this issue, but hopefully by being proactive with the doctor, you can get it resolved.

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