Time limit on patients claim reimbursements and an SNF that refused to bill 2nd insurance.

Is there a time limit for reimbursement? (Approx. 25k)

MJ has what's said to be very good insurance, she has Medicare (M) and secondary (B).

During MJ's SNF stays (1/1/22 – 6/30/22 intermittent), once MJ's M benefit was exhausted, SNF refused to bill her secondary insurance B said MJ would have pay OOP (Out of pocket).

B has confirmed that they cover the periods in question and requested superbills from the SNF. SNF has been less than cooperative in providing the codes to B that B needs to pay the claims(reimburse MJ) According to B, SNF has provided codes some but not all.

At this point, does MJ have any legal recourse?

Any suggestions to try, or insight as to why this happened, is appreciated. TIA

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A couple of the many tidbits-

SNF is a 5 star.

First SNF told me they didn't know what a super bill was or detailed coded invoice was for submitting to insurance. More than once a bare bones invoice was provided to MJ, SNF said that was their invoice.( I have that written in email).

SNF told MJ, while getting out of the office, SNF rep told MJ it was illegal for SNF to bill the 2nd insurance.

MJ has probably spent 100 hours in calls and paperwork. (everyone here probably knows how that goes)

submitted by /u/ForlifesQuestions
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