Received Medserv bill FOUR YEARS later!

ncmc

Not sure if this is the right forum for this, but my husband received a bill from Medserv before Christmas for X-rays he had in hospital in February 2015. The Bill is for €252. On the first bill it said something along the lines of ‘Irish Life insurance declined to cover this procedure’ We are not and have never been insured with Irish Life, we have always been with either VHI or Aviva (didn’t think Irish Life even did health insurance?) Also the procedure was fairly standard, admitted through A&E and referred to X-ray so I can’t think of any reason why our health insurer would have refused the claim (they’ve paid in similar situations before) It’s so long ago now that I can’t really remember the details or even say for sure which insurance company we were with at the time. With Christmas and one thing and another, we forgot all about it and yesterday he received a final notice threatening Stubbs Gazette and court procedures! I’m not sure how we should proceed with this, I should point out, we never received any bills from the hospital before Medserv got on the case, the letter before Christmas was the first we heard about it. I don’t feel we should have to pay, as I am fairly confident we would have been covered by health insurance and also it’s fairly outrageous that we’re only hearing about it four years on when it’s already gone to a debt collector. Thanks in advance for any advice.

L1011

Irish Life bought out Aviva (for health insurance). Its possible that they took so long to submit the request to them that the name change had happened; and that it was declined for being out of time.

You need to find out why it was declined. If they left it too late to submit - tough luck for them, not your problem.

ncmc

Thank you for that reply, I have dug out my VHI details and it seems we have been with them since January 2014, so we should have been covered by them at the time. Now I am wondering if my husband gave the hospital our Aviva details in error, we wouldn't have been covered by them so it makes sense that they would reject the claim. Would I have any comeback in this case? It's just so long ago, I can't remember any details.

Is it worth contacting the hospital or would they have completely washed their hands of it once they got Medserv involved?

L1011

In that scenario - if they never informed you the details were wrong until this late I'd consider it wrong to chase for it now when they could have requested correction in time; but the details were still given wrong - not sure what the legal situation is.

Hospital should be able to confirm what details were given.

Dav010

L1011 wrote: »

In that scenario - if they never informed you the details were wrong until this late I'd consider it wrong to chase for it now when they could have requested correction in time; but the details were still given wrong - not sure what the legal situation is.

Hospital should be able to confirm what details were given.

Op, having dealt with health insurers for over 20 years, I can assure you this is not unusual. If you changed insurer and gave wrong details at time of admittance/treatment, I’m afraid the fault lies with your husband. And despite what is posted above, they are very much within their rights to bill you for the procedure, the hospital may have been trying to get payment from your insurer for some time. If I were you, I would contact the hospital accounts dept and give them the correct VHI insurance details and ask them to bill the correct insurer.

L1011

The hospital's failure to notify of the refused payment for this long is still an issue - it's unlikely the insurer will entertain a claim this old

Dav010

L1011 wrote: »

The hospital's failure to notify of the refused payment for this long is still an issue - it's unlikely the insurer will entertain a claim this old

Have you dealt with medical insurers?

L1011

Dav010 wrote: »

Have you dealt with medical insurers?

Yes, from a billing systems side. They're going to raise serious questions about a payment request from that long ago.

The hospital should have know quite a long time ago that payment was being refused if the reason was "this isn't a validly insured patient" by Aviva/Irish Life.

Dav010

L1011 wrote: »

Yes, from a billing systems side. They're going to raise serious questions about a payment request from that long ago.

The hospital should have know quite a long time ago that payment was being refused if the reason was "this isn't a validly insured patient" by Aviva/Irish Life.

Ah, billing system side.

Well, from the owner of a Clinic which has direct billing with all insurance providers, I can assure you that contested claims can take considerable time to resolve. The claim can be contested for a multitude of reasons, and a relatively common one is incorrect details given by the patient. Once it is corrected, I have never known a valid claim to be refused. Hospitals and insurers are codependent, a billing mistake by the Hospital will be accepted, but wrong details given by the patient will not. All this time the Hospital may have been dealing with the wrong insurer due to the patient’s mistake, not the Hospital’s

Cath54

Insurer will accept claim for medical expenses up to 6 years after date of admission.

ncmc

Dav is it worthwhile contacting the accounting department of the hospital or do I have to deal directly with Medserv?

I understand that contested claims can take time, but four years??? If it was a case of incorrect details then surely it would be a case of them saying 'nope, not our customer' and the hospital getting in touch with us? It seems unfair that the first we're hearing about it is four years on when it's likely too late to get it sorted.

Cath, i think that 6 years is only for claims where you have paid and are seeking reimbursement. Hospital claims should be paid directly so not sure if the six year time limit applies.

Cath54

No. A hospital must submit a claim on behalf of the patient within 6 years.

ncmc

Ok that’s good to know, I’ll get on to hospital on Monday.

Dav010

ncmc wrote: »

Dav is it worthwhile contacting the accounting department of the hospital or do I have to deal directly with Medserv?

I understand that contested claims can take time, but four years??? If it was a case of incorrect details then surely it would be a case of them saying 'nope, not our customer' and the hospital getting in touch with us? It seems unfair that the first we're hearing about it is four years on when it's likely too late to get it sorted.

Cath, i think that 6 years is only for claims where you have paid and are seeking reimbursement. Hospital claims should be paid directly so not sure if the six year time limit applies.

Yip, just contact Hospital accounts Dept, explain error and give them correct insurance details and date from which cover started. They’ll take it from there.

Don’t underestimate how disorganised Hospital accounts are and how long it can take to sort out errors. Even dealing with social welfare/HSE can be a nightmare if patient details are not correct, we had a surreal incident a few weeks ago where social welfare claims dept were arguing with a patient over the phone about their date of birth.