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OK, just so I have this correct.
Everybody here thinks it is OK if: On day 365 the medical provider says, "you don't owe me anything, please don't worry about it, I submitted all the claims and will accept what ever I am paid." On day 366, a day late for the patient to file and be re-embursed, the medical provider says, "Sorry I lied, pay the full amount immediately or this goes to a collection agency." And furthermore there is case law supporting that this is the way things are supposed to work? |
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Actually, no. No one said it was okay, or that they approved, or that they thought the dentist was doing the right thing.
What the responders here may approve of or think is "okay" and what the law permits to happen, are not necessarily the same thing. The poster needs to determine whether or not, under his or her policy, the dentist was required BY THE TERMS OF THE POLICY to make the submissions. If he was, then the poster is in the clear. If he was not, then any issues about payment are between the poster and the dentist. You didn't come up with any case law clearing the poster from responsibilty, I notice. I'm not going to say it's impossible that the poster might prevail in court, if they wanted to go that far. But in the absence of a contracted responsibility on the part of the dentist to make the insurance submissions, the poster is responsible for the bill until a court says otherwise. |
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