Insurance denying claims because I took too long to file.

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Hopefully this is a relatively simple issue that someone can tell me if my health insurer is in the right or not/what I should do.

In December 2017, I regularly went to a therapist. During this period, I was still using my parent’s health insurance, which covered the therapist. During this time period my mom quit her job, so we switched to my dad’s insurance briefly before my mom got a new job, and we switched insurances a second time.

Both switches in health insurance were provided to the therapist, but they apparently did not file with the correct provider because in August of 2019, they came to me and said that I had outstanding charges. I told them that there were two insurance changes during the time I was there and to make sure that they filed with the correct provider (I again gave them the one they needed to file with for that time period).

In October of 2020, the therapist reached out again and said that they still had unresolved charges. They said they tried getting the correct insurance to pay, but they would not because I was covered by a different insurance at that time. I called both insurance companies in question, and we came to the resolution that I was indeed ONLY covered by my dad’s insurance at this time, but that they wouldn’t pay the therapist bills unless my mom’s first insurance provided a proof of termination letter.

I have now received that letter, provided it to my dad’s insurance, and now they won’t pay it because the claim has been filed too far after the date of service.

Two questions:

  1. Can the health insurance deny paying the bill because I’m claiming it too far after the date of service?

  2. If they can deny it, is the therapist at fault at all for incorrectly filing in 2017 and taking so long to attempt to resolve charges not once but twice?

Thanks in advance!

submitted by /u/jpj77
[link] [comments]
Hopefully this is a relatively simple issue that someone can tell me if my health insurer is in the right or not/what I should do. In December 2017, I regularly went to a therapist. During this period, I was still using my parent’s health insurance, which covered the therapist. During this time period my mom quit her job, so we switched to my dad’s insurance briefly before my mom got a new job, and we switched insurances a second time. Both switches in health insurance were provided to the therapist, but they apparently did not file with the correct provider because in August of 2019, they came to me and said that I had outstanding charges. I told them that there were two insurance changes during the time I was there and to make sure that they filed with the correct provider (I again gave them the one they needed to file with for that time period). In October of 2020, the therapist reached out again and said that they still had unresolved charges. They said they tried getting the correct insurance to pay, but they would not because I was covered by a different insurance at that time. I called both insurance companies in question, and we came to the resolution that I was indeed ONLY covered by my dad’s insurance at this time, but that they wouldn’t pay the therapist bills unless my mom’s first insurance provided a proof of termination letter. I have now received that letter, provided it to my dad’s insurance, and now they won’t pay it because the claim has been filed too far after the date of service. Two questions:
Can the health insurance deny paying the bill because I’m claiming it too far after the date of service? If they can deny it, is the therapist at fault at all for incorrectly filing in 2017 and taking so long to attempt to resolve charges not once but twice?
Thanks in advance!
submitted by /u/jpj77 [link] [comments]Read Morer/HealthInsurance

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