Help! Received a $5700 bill 18+ months after services
My significant other had a medical emergency 18 months ago, throwing up small amounts of blood. We rushed to Texas Presbyterian Hospital in Plano, where he underwent a CT scan and X-ray. Although his bleeding stopped, the doctors couldn't determine the cause and discharged him. We promptly paid bills from Texas Medical Services and Texas Radiology, and our insurance covered part of the expenses in November 2022. The total bill was $11,500, with insurance paying $1,700 and a $3,700 discount applied. We believed everything was settled until today when my husband received a bill from Texas Health Services for $5,700. How is this legal?
First I am thinking they are trying to get us for Balanced Billing. (When a provider bills you for the difference between the provider’s charge and the allowed amount. For example, if the provider’s charge is $100 and the allowed amount is $70, the provider may bill you for the remaining $30. A preferred provider may not balance bill you for covered services.). That’s not allowed so I’m surprised they are trying.
Next I started looking into can they do this 18 months later. I am internet savvy but do not trust everything I read. I came across the following law:
Texas has a "timely billing" law. It requires health care service providers to bill a patient no later than the first day of the 11th month after services were provided. If the bill is not sent within the timeframe in the law, the health care service provider cannot try to collect payment for certain charges. This includes:
Charges a patient could be reimbursed for by a health plan Charges that a patient would not have owed if the provider billed them in a timely fashion The details can be found in the law linked below.
Texas Law-Texas Civil Practice and Remedies Code, Chapter 146 This chapter prevents health care service providers from collecting on medical debts that were not billed in a timely fashion.
I’m not a lawyer, but based on what I read here it says sorry hospital, you cannot collect from me. Or am I wrong?
submitted by /u/Mind4rent
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