Late insurance claim settlement

A: Most insurance policies allow medical bills be submitted up to 6 months after treatment. The contact information for claims submission is included on the ID card and in the back of the policy itself. In most individual health insurance policies, the cost of outpatient physical therapy treatment barely exceeds a typical $1000 policy deductible, so insurance usually does not play a big role in paying for physical therapy for commercial insurance patients. The objective is to choose a deductible that is high enough to bypass the expensive insurance procedures for these smaller medical bills and save enough in insurance premiums to be able to pay smaller amounts out-of-pocket. The more significant issues are: 1) If no third party payer arrangement was made in advance, then there is no assurance that the service provider will accept the health plan's approved amount as full payment. You may not benefit from PPO discounts. 2) Obviously there is no 'assignment of claim' and no timely response to previous billing, which then makes the patient financially liable for the full amount of the bill. The lesson to be learned is that should always be some communication about payment between patient and medical service provider prior to receiving medical service - basically who is responsible, how much, and what billing procedures will be followed.