Legal Question in Credit and Debt Law in Tennessee

You may or may not owe the charge depending upon the insurance "contract" with the medical service provider. From a general standpoint, you are legally obligated to pay the medical bill with respect to provided services including any portion of the bill that is not paid by insurance. The medical service provider has six years from the date the service is provided to make a personal claim against you or to file suit against you. Since the services were rendered in 2009, which is well within the six year period, the medical service provider is able to make the claim and insist on payment.

However, as noted at the outset, you may not be obligated to pay the outstanding balance if the medical service provider has an agreement with the insurance company to accept the insurance payment as full payment of the bill or claim. As an example, if the medical service provider is part of a PPO or other network that is administered by or "honored" by the insurance carrier, the medical service provider may be obligated to accept in full satisfaction of a bill the patient's co-payment, if any, and the payment by the insurance carrier, In such cased, the medical service provider is then required to "write-off" the outstanding balance as a PPO or network adjustment. If the service provider fails to honor the agreement it has with the insurance company, it risks sanctions and other possible actions including a termination of the agreement with the insurance carrier.

I suggest that you contact your insurance carrier and request a copy of the EOB (explanation of benefits) relative to this particular charge. That will show you what obligation, if any, you have with respect to payment of the medical bill. If the EOB shows that you have no obligation other than the co-payment, you then need to contact the medical service provider and discuss the situation with them asking them to review the bill. If however, the EOB shows that you have an obligation in addition to the co-payment, then you will most likely have to pay the bill. Of course, you can also ask the insurance carrier to review the claim to see if they may have missed something when adjudicating the claim for payment.