Here is the short of it: I’ve was seeing a therapist for about 2 years, and never got any bills or anything, and most of the visits went through fine. Apparently some were either never sent through or never approved by my insurance, and starting in December I keep getting new appointment bills going back further and further. In December I got a bill for August 2021, got that worked out, and now I have a new bill for July and May, and this will continue every few months going back further and further. I expect this will continue until sometime in 2023-2024 when I will finally get the first “in-limbo” bill from May 2020. Is this even legal?
The long story: ************
I was seeing a therapist from May 2020 to August 2021 when he left the practice. As far as I knew everything was covering fine as I was constantly seeing “Approved” claims and getting bills for just the $5 copay: so all is well. Until December 2021, when I get a bill for $400, saying I need to pay for two appts in Aug 2021 as my insurance denied. I called both companies and thought it was straightened out after much back and forth.
Again I log on yesterday, and see $400 due again, this time for appts further back, in May and July 2021. I’m trying to figure out what is going on and I click more tabs, eventually finding out there are THIRTEEN APPOINTMENTS in “limbo” from going back to mid 2020! Keep in mind 60-70% were approved, this is a random fraction of my appointments, which is why I didn’t notice they weren’t approved at the time.
This is a bit complicated, but all of this time I was seeing ‘Mr. Person’ who was overseen by ‘Mr. Overseer’ as they do kind of a student therapy thing, so I remember now that the Therapy office told me all that mattered was that ‘Mr. Overseer’ was in network as he consults with Mr. Person about my therapy when I’m not there, and they assured me Mr Overseer was covered. Turns out 1/3 of the time they were still billing under Mr. Person. These “in limbo” bills are stored in a place I never would have thought to look.
I didn’t know any of this, and if things go the way they have, every few months I am going to get an older and older bill, until we get back to May 2020. My fear is that I cannot even see my appts from 2020 on my insurance site as I changed my plan slightly in 2021. By the time I get the bill for 2023, it is going to be so convoluted I don’t know it will get figured out. My insurance says there is nothing they can do, the claim must be billed under a provider in network, but my therapy office told me earlier that they cannot rebill until my insurance denies.
Finally the insurance said they called my provider and my provider will re-bill everything correctly, but there billing department is so weird I don’t buy it.
********
So who is on the hook here if all of my appointments were the same, and 2/3 were approved, but the office billed a random one out of three appointments under a different name? If the claims aren’t denied until years later, and I don’t see the bill until years later, am I on the hook? At what point can the provider stop sending me old bills that they refuse to deal with now?
And what problems should I forsee trying to get insurance to cover claims 3 years old once they finally deny and I finally get the bill and can actually do something about it? By 2024 I will be married and under a different insurance.
submitted by /u/melonchollyrain
[link] [comments]Here is the short of it: I’ve was seeing a therapist for about 2 years, and never got any bills or anything, and most of the visits went through fine. Apparently some were either never sent through or never approved by my insurance, and starting in December I keep getting new appointment bills going back further and further. In December I got a bill for August 2021, got that worked out, and now I have a new bill for July and May, and this will continue every few months going back further and further. I expect this will continue until sometime in 2023-2024 when I will finally get the first “in-limbo” bill from May 2020. Is this even legal? The long story: ************ I was seeing a therapist from May 2020 to August 2021 when he left the practice. As far as I knew everything was covering fine as I was constantly seeing “Approved” claims and getting bills for just the $5 copay: so all is well. Until December 2021, when I get a bill for $400, saying I need to pay for two appts in Aug 2021 as my insurance denied. I called both companies and thought it was straightened out after much back and forth. Again I log on yesterday, and see $400 due again, this time for appts further back, in May and July 2021. I’m trying to figure out what is going on and I click more tabs, eventually finding out there are THIRTEEN APPOINTMENTS in “limbo” from going back to mid 2020! Keep in mind 60-70% were approved, this is a random fraction of my appointments, which is why I didn’t notice they weren’t approved at the time. This is a bit complicated, but all of this time I was seeing ‘Mr. Person’ who was overseen by ‘Mr. Overseer’ as they do kind of a student therapy thing, so I remember now that the Therapy office told me all that mattered was that ‘Mr. Overseer’ was in network as he consults with Mr. Person about my therapy when I’m not there, and they assured me Mr Overseer was covered. Turns out 1/3 of the time they were still billing under Mr. Person. These “in limbo” bills are stored in a place I never would have thought to look. I didn’t know any of this, and if things go the way they have, every few months I am going to get an older and older bill, until we get back to May 2020. My fear is that I cannot even see my appts from 2020 on my insurance site as I changed my plan slightly in 2021. By the time I get the bill for 2023, it is going to be so convoluted I don’t know it will get figured out. My insurance says there is nothing they can do, the claim must be billed under a provider in network, but my therapy office told me earlier that they cannot rebill until my insurance denies. Finally the insurance said they called my provider and my provider will re-bill everything correctly, but there billing department is so weird I don’t buy it. ******** So who is on the hook here if all of my appointments were the same, and 2/3 were approved, but the office billed a random one out of three appointments under a different name? If the claims aren’t denied until years later, and I don’t see the bill until years later, am I on the hook? At what point can the provider stop sending me old bills that they refuse to deal with now? And what problems should I forsee trying to get insurance to cover claims 3 years old once they finally deny and I finally get the bill and can actually do something about it? By 2024 I will be married and under a different insurance. submitted by /u/melonchollyrain [link] [comments]Read Morer/HealthInsurance