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medical billing question

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jams92

Member since 1/12

6105 total posts

Name:

medical billing question

When you (or your kids) go to your doctor for a non-well visit; about how long does it take for you to receive your bill?
Here is my situation:
took my son for a sick visit in March and paid the copay. Within 2 weeks from the appt, I got the notification from Aetna saying xx amount was submitted, yy amount was covered (90%) your balance may be zz amount. Great, no big deal, I will pay it when i get a bill.
Fast forward to now (6 months later), I am just getting that bill from the dr. They are not telling me it is past due or anything like that, it just aggravates me that it takes them 6 months to bill me, especially when I had 2014 flex spending money I could have used on this specific bill. I have gone in at least twice since and have asked if I had a balance and they tell me no.

I have an appt this weekend and am debating on speaking to the office manager about their delay in billing. But I am wondering, perhaps this is the norm.
would you say something about it or just let it go?

Message edited 9/15/2015 10:08:38 AM.

Posted 9/15/15 10:03 AM
 
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BlessedMomma
LIF Adult

Member since 12/11

6163 total posts

Name:
Momma Bear

medical billing question

6 months is not the norm. Something must have slipped through the cracks. It should take tops 60 days to receive a bill and even that is a long time.
If they electronically submit their claims they usually get a payment within 2-4 weeks. And even that is applied electronically, its not really manual anymore though some practices still do manual payment entry.
Still a bill should have been sent within 30 days.

Posted 9/15/15 10:06 AM
 

LuckyStar
LIF Adult

Member since 7/14

7274 total posts

Name:

medical billing question

I'm not sure why you would get a bill at all. If the doctor accepts your insurance they have to accept whatever the insurance decides to pay them, plus your co-pay.

Posted 9/15/15 10:51 AM
 

Mara1017
LIF Adolescent

Member since 5/11

696 total posts

Name:
Mara

Re: medical billing question

Posted by LuckyStar

I'm not sure why you would get a bill at all. If the doctor accepts your insurance they have to accept whatever the insurance decides to pay them, plus your co-pay.



This is not true. It depends on what your policy says. You can be responsible for a deductible and/or co-insurance. I do not pretend to completely understand the whole insurance system but I do know that I am responsible to pay up to my deductible amount over the year.

Posted 9/15/15 11:31 AM
 

LuckyStar
LIF Adult

Member since 7/14

7274 total posts

Name:

Re: medical billing question

Posted by Mara1017

Posted by LuckyStar

I'm not sure why you would get a bill at all. If the doctor accepts your insurance they have to accept whatever the insurance decides to pay them, plus your co-pay.



This is not true. It depends on what your policy says. You can be responsible for a deductible and/or co-insurance. I do not pretend to completely understand the whole insurance system but I do know that I am responsible to pay up to my deductible amount over the year.




Ah, ok, I misunderstood- I didn't realize there was a deductible.

OP, 6 months is an insane amount of time and I would absolutely speak with the billing department!

Posted 9/15/15 11:37 AM
 

Lucky09
2017!

Member since 1/06

7539 total posts

Name:
DW

Re: medical billing question

I work in finance for a hospital/university and as an internal rule we can't bill patients for things that are over a year old. It could be that your insurance took 6 months to pay the bill (happens sometimes when claims are pulled for internal medical review, disputed, etc) and the Dr's office just received payment from the insurance company and calculated your portion now.

I'm not sure how you would use 2014 flex spending for an expense incurred in 2015. I didn't think you could do that with flex spending, but i could be wrong (or your plan could have some sort of a loophole that allows it).

Posted 9/15/15 12:47 PM
 

jams92

Member since 1/12

6105 total posts

Name:

Re: medical billing question

Posted by Lucky09

I work in finance for a hospital/university and as an internal rule we can't bill patients for things that are over a year old. It could be that your insurance took 6 months to pay the bill (happens sometimes when claims are pulled for internal medical review, disputed, etc) and the Dr's office just received payment from the insurance company and calculated your portion now.

I'm not sure how you would use 2014 flex spending for an expense incurred in 2015. I didn't think you could do that with flex spending, but i could be wrong (or your plan could have some sort of a loophole that allows it).




Aetna notified me that the claim was submitted within 2 weeks of the appt; and it stated what they were covering. I would find it odd that Aetna took 6 months to pay out when the claim was submitted and acknowledged in a timely manner....but i guess anything is possible.

in regards to the flex spending, we have until March 15 (or 30, i would have to double check) to use our flex spending money for the prior year

Posted 9/15/15 1:48 PM
 

jams92

Member since 1/12

6105 total posts

Name:

Re: medical billing question

Posted by Mara1017



This is not true. It depends on what your policy says. You can be responsible for a deductible and/or co-insurance. I do not pretend to completely understand the whole insurance system but I do know that I am responsible to pay up to my deductible amount over the year.




yes this exactly - i have to meet my deductible. Once i meet it I am 100% covered, until that point, i am 80% covered

Posted 9/15/15 1:49 PM
 
 

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