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CalAttorney2, Lawyer
Category: Consumer Protection Law
Satisfied Customers: 10244
Experience:  I am a civil litigation attorney representing individuals and businesses.
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My dentist never billed the insurance company and now almost

Customer Question

My dentist never billed the insurance company and now almost 2 years later they are threatening to send me to collections. Back when the services were performed the dentist looked up the deductible amount and I made that payment on the spot for approximately $350. Now I keep getting threatening messages from the dentist saying I owe the entire bill and they are going to send me to collections if payment is not made or payment arrangements are not made. I live in Maryland. The difference of the bill is approximately $1200 - but I think that is the full amount of the bill and they are not providing credit for the amount that was paid and my only responsibility.
Submitted: 2 years ago.
Category: Consumer Protection Law
Customer: replied 2 years ago.
I understand that the SOL in Maryland is 3 years so the SOL defense doesn't apply. However I believe that there has to be a separate SOL for timeframe to submit a claim and collect on it. The dentist office has just started calling me or harassing me as of the past 6 weeks on this bill.
Expert:  CalAttorney2 replied 2 years ago.

Dear Customer,

I am sorry to learn of this matter.

Unfortunately these kinds of issues can be a little complicated. To start, you will want to carefully check the paperwork you signed at the time that you received your care. You want to confirm that the office was responsible for billing your insurance, and not you.

Second, you will want to see if you can submit a bill to your insurance now. Some insurance companies will accept late billing for services as long as the coverage was intact at the time of service. If this is the case, your carrier will pay for the amount due, and deal with this problem for you.

Third, assuming that you were the one responsible for billing your insurance, you can try reaching a settlement agreement with the dentist (paying them part of what they are demanding in full, this is especially true if they offer billing of insurance as a "courtesy" and they didn't inform you - if they informed you sooner, you could have done something about it - their failure to inform you earlier should significantly reduce your liability).

Fourth, assuming that they were the ones responsible for billing your insurance (again under the terms of the service agreement you signed), you can reject their demand for payment and tell them that their negligence in failing to bill acts as a breach of contract and they are barred from collecting the additional amount from you.

Customer: replied 2 years ago.
I no longer go to this dentist and do not have a copy of initial disclosures. But this dentist was a provider under my insurance plan and they agreed to bill my insurance. The fact that they had always billed my insurance directly up until this time and that the billing secretary always looked.up Co pay/coverage amounts at the time of service should place the burden back on them I believe. Despite being offered the option to have them bill me my Co pay or pay up front, I chose to pay it up front. Dont these factors shift the burden back to them?
Expert:  CalAttorney2 replied 2 years ago.

Dear Customer, I believe that based on the circumstances as you have posted them, you are more likely than not, not responsible for this bill. However, my assumption is not really a legal authority here, and isn't what is really helpful here.

You can follow the above dispute resolution tips - even though you are no longer a patient with them, you can still ask them for these documents (they should produce them to you without having to go through litigation).

Short of filing a lawsuit, you can try to mediate the dispute with them - contact your local bar association and request referrals to mediators, a third party neutral can often help you reach a mutually agreeable resolution. Use the bar association's referrals to contact a mediator or two, the mediator will then contact the other party to set up a mediation session, and you can go from there - hopefully resulting in a formal or written settlement agreement, and save yourself the time and expense of litigation.

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