Some common myths:
1. Medical providers are required to bill your insurance company.
2. Insurance companies have to pay your medical bills.
The truth is, you are responsible for paying your medical debts. Now, if you happen to have medical insurance, AND the insurance company receives the medical bill in accordance with its stated requirements AND the medical service is covered under the policy, then and only then is the insurance company responsible for paying the debt. Pay special attention to the words, “receives the medical bill in accordance with its stated requirements” because this is what gets people into trouble more often than not. As a convenience, most medical providers offer to bill your insurance company. However, accepting their offer does not relieve you of the responsibility of ensuring the medical bill gets paid. It’s not uncommon for medical providers to submit medical bills after an insurance company’s deadline for filing. In some cases, the provider may, for a number of odd reasons, not submit the medical bill at all. Regardless of the reason, the bottom line is that the consumer is still responsible for ensuring the insurance company “receives the medical bill in accordance with its stated requirements”! In some cases, your insurance company may reject the bill or flat out refuse to pay. The fact that your insurance company did not pay is not the medical provider’s concern! The medical provider has the right to expect you to pay the bill in a timely manner. You may have to argue with your insurance company and even go through dispute resolution but while you’re doing that, the medical provider is still entitled to timely payment. The best thing you can do is communicate with your medical providers to let them know you are working to resolve the issue. In the end, you may have to pay the provider yourself and then work with your insurance company to get reimbursed. Always read the medical provider paperwork (contract for services rendered) carefully!