Wrong insurance billed, correct insurance denied for “timely filing”

Sorry for the length of this but I figured it’s best to provide all the details upfront. November 2023 I had a few tests done. I had met my deductible for the year and knew these tests would be fully covered by my insurance so I didn’t give it a thought when I never got a bill from the provider. May 2024 rolls around and I need another test. As anticipated a month rolls by and I get a bill since it’s my first doctor’s visit for the year. The Problem(s): -This bill list the 3 tests I had back in November of 2023 as “denied” due to me not having been covered by the insurance plan they submitted to at the time. -This bill also lists my May tests as denied for the same reason.

I’m certain I’m covered by health insurance so I go to my Aetna app to look at the EOBs and see that none of these dates had been submitted to them. (And confirm that I have had no lapse in coverage at any point).

I go back to the billing site that sent me the bill and check the insurance they had me under. It was a different Aetna plan under my husband’s old company that I hadn’t been covered by since March of 2022. Yes I had made visits to this provider while covered by that old insurance plan however I have been billed by them under my current insurance for 12 visits leading up to the November 2023 visits that began the incorrect billing.

While on that site, I updated my insurance info to my current insurance and it appears they resubmitted the claims.

Since then: -the May 2025 appointments were resubmitted to the correct plan and approved. -The November 2023 appointments have been denied citing “timely filing” which according to Aetna was 120 days. -I am now being told I owe for the November 2023 appointments.

Important points: -I have not once been billed for the November 2023 appointments before June 28th 2023. 7 months and 20 day later I get the bill but it seems that it was prompted by the visit I had in May of 2024 since it included that. -No phone calls or emails regarding the outstanding balance I supposedly owe for nearly 8 months. $1,235 so it’s not nothing -I never made any changes to my insurance with them since it changed to my current plan in March of 2022 and they had billed the 12 services previous to November 2023 to my current insurance. -every visit I have with this provider they request my insurance card and I provide it to them upon check in.

My worry is they’ll tell me that it doesn’t matter what happened and that they have provided the services so therefore I owe them. Even if it appears that it was their error or the billing companies error.

I spoke with the billing company today (after I got a robocall from them saying my insurance company hasn’t responded) and explained everything and they said they’re going to investigate but I have very little faith this will get resolved in my rightful favor without a lot of bother, if at all.

Any advice or next steps?

submitted by /u/Latter-Ad-9030
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