Legal Question in Business Law in California

limitation on billing for medical services

Is there a time limit that a doctor can bill for medical services.


Asked on 3/09/09, 7:04 pm

1 Answer from Attorneys

Bryan Whipple Bryan R. R. Whipple, Attorney at Law

Re: limitation on billing for medical services

There are three possible limits, possibly others:

(1) There is an outer time limit on bringing a lawsuit to collect an unpaid debt, imposed by one or another of the statutes of limitations. Since a statute of limitations sets an outer limit on a tardy attempt to enforce a bill, it acts as a sort of time limit on presenting a bill with any reasonable hope of collecting it from a reluctant patient. In general, a doctor bill would have its roots in a written contract, and the statute of limitations on a written contract is four years from the date the doctor could have sued, and that would probably be 30 to 60 days after the services were rendered, so figure any billing more than four years and a few months after the services were rendered is probably subject to a defense of limitations. However, I must add that the statutes of limitations are subject to numerous exceptions and rules of interpretation.

(2) Aside from the statutes of limitations, there are various fuzzy legal doctrines that could be raised as a defense to a late bill, such as breach of a contract term requiring good-faith prompt rendition of bills, the equitable doctrine called "laches," and perhaps others.

(3) The ethical standards or professional practice rules of the medical profession may deter or bar late tendering of bills. I know nothing in particular, however. You might research this on line or check the State Web sites for licensing of physicians, etc.

There may be special rules for doctors practicing under various public or private insurance programs or group or corporate practices such as Medicare, Medi-Cal, Kaiser, Blue Cross, etc.

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Answered on 3/09/09, 8:48 pm


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