Medical services billing may have different time periods depending on the healthcare center, patient’s insurance company, and state laws.
Many insurers advise medical service providers to bill them in a chronological and timely manner, the latest being as 12 months’ cut-off time. Healthcare service providers should wait for their payment before billing the patient for the balance amount if any.
How long after medical services can you be billed? It depends on what time frame insurers have in place for reimbursing your medical bills. If there’s a written agreement to pay at the time of the clinic visit, the medical center has six years to collect it from the appointment. If there’s no agreement, doctors may have to wait four years to collect the billed amounts.
You may need to understand medical bills, insurance policy, statutory, and payment terms.
Understand your Medical Billings
Medical billing is slightly an intricate matter. Most patients complain about the bills being too expensive or a service cost they never got treated for.
What do they Cover?
Medical bills cover the fees for services, advice, treatment, diagnosis process, lab reports, etc. You may ask your insurers to check cost estimates for different healthcare providers. You may find fees are quite different for the same service, diagnosis, or lab test.
What a Billing Cycle is and how it works?
You may visit a certain healthcare center and ask about the services and other relevant supplies you will receive. This will clarify your doubts on upcoming charges you may have to see in the bills.
If still not clear about what insurance will cover, ask the medical center for the procedure codes. Then you may contact your insurers to find if they cover these services in the plan. If so, get an estimate of how much the service will cost with your insurers.
If cost is still on high-end, you can again ask your insurers if they have other healthcare centers that provide the same service for less.
Preauthorization
Few insurers need pre-authorization to cover a certain medical service or medication. The insurance company will collect more information to determine whether they cover the services and medications in the plan.
Co-Pay
It’s an out-of-pocket amount you pay during each visit. Always provide your health insurance policy number, other information to the healthcare centers for clarity about the billing part.
Once you have received the services, the medical coder will identify all services, prescriptions, and what supplies you may have received. Hence, this will ensure a clean billing cycle.
Read you bills
When you receive your medical bill from your healthcare service provider, kindly ensure it’s about the services which you received at their clinic. Pay attention to codes, descriptions, and price column.
If any confusion, check with the healthcare center to understand your bill, You may check the following:
- the statement date
- your unique account number with the healthcare center
- appointment date
- description
- charges
- billed charges
- any adjustments
- insurance payments, and
- patient’s payments
What’s Explanation of Benefits (EOB)?
An EOB is a document that you may receive after the healthcare center files a claim for your medical treatment and services the insurers have agreed to pay for on your behalf.
This document must show the health insurance member’s full name and ID number, Patient Account Number, service provider name, claim number, date of service, service codes, total amount, and net amount.
This document also includes a Reason Code Description that is about the reason why your insurers did not cover a charge.
Statute of Limitations on Medical Debt
The quick answer is medical debts may disappear from your report after seven years, but it doesn’t exonerate you from paying it at any stage. Medical bills never expire. It has a statute of limitation.
Statute of Limitations
A statute of limitation is the time a creditor has to take legal action on you for nonpayment. Your creditor will take a certain amount of time to sue. That depends on the state law where you signed the contract or agreement.
Contract Types
A statute of limitations on your medical debt largely depends on the type of contract governing the debt deal.
Oral contracts
These are verbal agreements you make for returning the money, with no written evidence. Like you lend money to your friend, but nothing comes in writing.
Written contracts
It’s the document that you may sign, including terms and conditions for receiving and repaying the money. Most of the loans for a car, person to person, mortgages, etc., fall under the written contracts category.
So medical debts fall under this category. You must sign paperwork before the medical center starts any medical treatment. It’s an agreement that you will repay the medical expenses to that medical healthcare center.
Promissory note
A promissory note is a written contract with a lighter note. It’s an agreement between two parties or people with the repayment terms and conditions set-forth with mutual consent.
Open-ended contracts
It’s a revolving balance; you can repay and borrow it again –more like a credit card.
Each state has a statute of limitations for each kind of debt. You may find such limitations in your state.
Credit Reporting Vs. Statutes of Limitations
Debts can disappear but never die.
After a considerable lapse of time, usually seven years, your credit reporting will be clear of most debts. However, your debt still exists in full. It’s a matter of time until any credit bureau unearths it. Hence until then, it’s no longer visible to anyone looking for your credit history.
Similarly, when the statute of limitations on your medical debt expires, it doesn’t mean the debt goes away. It simply implies that you are no longer legally responsible for the repayment of debt.
However, you must remember that you can still face a lawsuit in a court of law for repayment of medical debts.
So, whenever the statute of limitations on that particular medical debt expires, it’s your or your attorney’s responsibility to inform the court that this has happened.
Conclusion
You may count that Statutes of limitations are protection for consumers. You must stay informed about your debts and your rights whatever state you live in.
If your medical debts are increasing quickly, you may talk about flexible repayment plans. Healthcare center service providers are more flexible and more understanding than traditional moneylenders and creditors.