I'm in the middle of another dispute between an in-network doctor's billing office and my health insurance company (HIC). My health insurance has not yet paid the bill due to a dispute over some diagnosis code used.
Instead of resolving the dispute with my health insurance company, the doctor's biller is sending me a bill for the full amount - prior to any final payment or Explanation of Benefits (EOB) which would show my patient responsibility amount due.
I have not yet received correspondence regarding these claims from the HIC, but I have called both the biller and HIC regarding this dispute attempting to get them to resolve the dispute so I will know my amount due based on final EOB for each claim.
My question is regarding the amount of time allowed for the HIC to dispute this claim with the biller before they are required to either accept or deny the charges formally with an EOB sent to me. Is there a legal time limit for the HIC to process each claim received? I hate being stuck in the middle of billing disputes like this and receiving bills for claims which I do not yet have an official health insurance patient responsibility amount due yet.