So, I've been researching for a quite a bit and haven't been able to find a case or ruling that relates close to my situation.
I went to a sleep specialty physician about four years ago who was covered under my insurance. I provided my insurance information, including billing numbers over the phone a month prior to the visit. The office never contacted me to make me aware that the doctor's office visit would not be covered. I arrived at the appointment, went to pay my copay upfront, and the front office representative told me there was no copay. Upon exit, the office made my next appointment, I asked again if there was a copay, they told me no. I made my next appointment, and once again was met with the same procedure. No copay taken, no information on what the insurance would pay for, kept being met with the same response by the front office when I went to pay.
Before my third appointment, I got a bill directly from the doctors office saying I owed $250.00 for the first visit because my insurance had not met the deductible. I obviously was confused because, times where a procedure was not covered and or a deductible was not met, the office made me aware of the price. So I called the office and asked about the bill, and they tell me they are not liable for not telling me if an insurance doesn't pay for an office visit and I will actually be getting another bill soon for $180 for the second visit. I, of course, tell the office that I will not be paying them due to their lack of disclosure and I will be cancelling my upcoming appointment. I then made the insurance aware of the incident, I never received an "explanation of benefits" from the insurance and I told the practice I was not going to pay due to their lack of competency. I told the office I would pay a reasonable copay, they refused. Years pass and now this month I get a notice of a civil pursuit from a legal office representing the physician asking for $600 in medical and legal fees. The legal office representing the case has been quite unhelpful so far, because they perceived me as not responding to their case back in June as "avoiding" penalty, but I had literally moved to a different state. I made them aware when a representative called me in June, when they tried to serve me papers, which took them two months to send me the documents to my new address.
Of course, this would be a different situation if this was an emergent issue within a hospital where a procedure or service was required without insurance verification and billing is done post visit. But these were regular doctor's office visits where no procedure other then a consultation was provided. Do I have any legal recourse to defend myself from these surprise claims from 4 years ago?