Harry Gross: Billing delay isn't her fault
Dear Harry: I am writing on behalf of my sister-in-law who is 86 and does not hear very well. Two years ago, her doctor told her to go to the hospital for some epidural injections and other treatments for spinal problems that she had. She was told by the billing department that her co-pay would be $200 after Medicare and insurance. She paid the bill and heard nothing until a few months ago. She contacted the hospital to see if there was any more money due, and she was told by the billing department that they never sent her bill to her insurance company. They assured her that everything would be OK. Last week, she got a bill from a collection agency seeking $4,000. I contacted her insurance company and was told they could not honor a bill that was more than two years old. Where do we go from here? She has excellent credit, and is very careful about paying all her bills on time. She should not have to pay this bill.
What Harry says: You are absolutely right. This is a problem between the hospital and the insurance company. Step one is to notify the collection agency that the hospital was initially at fault for not submitting the bill to the insurance company. Once it was submitted, the insurance company should have paid it. I'm not aware of any insurance company provisions that permit a denial of a claim because of a submission beyond two years. The next step to follow is to contact the Pennsylvania Insurance Department at 215-560-2630. They will help you get this straightened out.
Write Harry Gross c/o the Daily News, 400 N. Broad St., Philadelphia, PA 19130. Harry urges all his readers to give blood - contact the American Red Cross at 800-GIVE LIFE.



