Legal Question in Insurance Law in Connecticut

Re: Doctor's Didn't Submit to Insurance Company

Whether there is a time limit to submit claims to the insurance company will depend on the provisions of your plan. You can check your plan booklet to see if there are any specific time limits that would apply in your circumstances.

Regardless of whether the plan sets out time limits, you should make sure the bill is submitted to the insurance plan as soon as possible. If the insurance pays under the plan, you'll be on track. If not, you will receive a denial from the insurance plan, which will give you: 1) The opportunity to appeal the denial under the insurance plan and 2) The opportunity to discuss with the doctor's office the circumstances which led to the bill not being paid and possibly negotiate a solution with the doctor's office.

Be sure to ask for and retain copies of any submissions to the insurance company (ask the doctor's office to send you a copy if they are submitting the claim) and any explanations of benefits that you or the doctor's office receive in response.