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TexLaw
TexLaw, Attorney
Category: Legal
Satisfied Customers: 4430
Experience:  Lead trial/International commercial attorney licensed 11 yrs
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New charges for old medical services?

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Hi there. I just received a medical bill for charges they state I haven't paid dating from June 2010 to December 2011. However, I have been paying the full balance on any statements from this healthcare system on time, as recently as this last month, and have not seen these charges (up to $2600) on my balance/bill. Is this legal? They also state that failure to pay the amount will result in the reversal of discounts and insurance adjustments. Is that legal? Should I contact my insurance providers or should I fight this, or do I need to pay these new charges on old services?
Are the charges for services you've already paid for? Or is it for services they have not charged you for yet?
Customer: replied 5 years ago.
Thank you for your response. These are for medical services from June 2010 to Dec 2011. They are for services that were already reimbursed by insurance and adjusted and included on statements I have paid previously I believe, but they are stating I have an outstanding patient balance. However, these charges/this balance has not been on any recent statements until now. I have maintained a zero balance on all statements. They just recently moved to a third party billing system. I feel like they went back and reevaluated charges- it feels fishy. Have you ever heard of this happening before?
Yes, unfortunately it happens all the time.

Whether it is legal or not has not actually been established in the courts. I think it is an abhorrent practice.

You need to contact them and argue that the medical provider agreed to take your insurance and that you would only have to make a co-payment. You've made the payments and the medical provider has been paid by your insurance company. You don't owe them anything extra and did not agree to pay more than what your insurance would pay for the same services.

You will probably have to argue this again and again with them until they will agree to stop billing you. Send a certified letter stating this and also call them and tell them that you don't owe anything more and that they have already been paid. I would also turn this over to your insurance company and ask them to inform the medical provider that you don't owe anything.

You could take them to court and challenge this if and when they file something on your credit report. At that point you can sue them for fraudulent/negligent damage to your credit and breach of contract. At this point, you are still in the non-legal intervention stage.
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