North Carolina coordination of benefits and untimely claim

arbarne2

New Member
Jurisdiction
North Carolina
Hi,
I am trying to get my health insurance to cover claims that were previously denied. I have been covered by BCBS for over 8 years for my primary insurance coverage. I recently got bills in the mail for my medical claims from 2015, stating that I owe because BCBS retracted their previous payments for these claims. I called BCBS to find out why they retracted, and they said it was because another insurance was my primary. I started a new job in December 2014, and was apparently auto-enrolled in our employer health plan, without realizing it. I had no idea that I was signed up for this and since I knew I was signed up for BCBS, I continued to file my insurance with them and they paid the claims, so all was good, until they retracted payments. I got in touch with my HR department at work to get information on the employer health insurance (united healthcare) and called all of my service providers with claims from 2015 and asked them to please file them with UHC since BCBS is rejecting them. The problem is that it is past the 180 day filing deadline for UHC, so I am afraid they will deny to pay. Like I mentioned, since BCBS originally paid all of these claims, I did not know that I needed to file it with the other insurance until it was too late. Any advice for which insurance is most likely to pay these claims, and how I can get that to happen, will be a huge help. To think that I was wasting money on two primary health plans last year is frustrating enough, but the idea that neither of them will take responsibility for the medical claims is scary. Thanks for any advice you can provide.
 
Insurance companies make their own rules, and operate under state insurance laws.

I suggest you work with your employer.
As you suspect, the 180 day filing period might now disallow any claims.
Ask if that can be waived.
Otherwise, it's YOUR bill, you might have to pay it all.
Next time find out the rules before you act.
 
Insurance companies make their own rules, and operate under state insurance laws.

I suggest you work with your employer.
As you suspect, the 180 day filing period might now disallow any claims.
Ask if that can be waived.
Otherwise, it's YOUR bill, you might have to pay it all.
Next time find out the rules before you act.

Thank you for your quick response.. I will continue to work with my HR department to see if they have any leverage with my employer health care program. My secondary provider also told me that if I show the other insurer (united health care) proof that the claim was filed in a timely manner with the secondary insurance, and paid in full, before being rejected, they may be more lenient on accepting the late claims.
 
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