Providence waited 16 months to bill me – must I pay?

Hi, In January 2023 I had an uneventful trip to the Providence ER. Months later I logged into my portal to see if I owed anything. There was no record of my visit and there was no balance owed. Weird, but I moved on.

Last week (16 months later) I got a bill for $185 from Providence, the amount after insurance. I definitely met my deductible last year (and this year), so it should be $0.

But also, it appears in our state (Oregon), that OAR 436-009-0010 – Medical Payment and Billing says "2.a – Medical providers must bill within (A) 60 days of the date of service; […] (b) If the provider bills past the timelines outlined in subsection (a) of this section, the provider may be subject to civil penalties as provided in [various OARs]. (c) When submitting a bill later than outlined in subsection (a) of this section, a medical provider must establish good cause. […] (e) When a provider submits a bill more than 12 months after the the date os service, the bill is not payable, except when a provision [about workers comp or litigation] is the reason[…]"

So it seems to me like they missed the boat and shouldn't be paid. Do I just call them and tell them they waited too long and they are possibly subject to civil penalties?

submitted by /u/MonsieurBon
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