Does Statute of Limitations Not Begin to Run Until a Medical Bill Is Submitted to the Insurance Company ?
In Temple University Hospital v. Pennsylvania Department of Labor and Industry, 873 A.2d 780 (Pa. Cmwlth.), petition for allowance of appeal denied, 583 Pa. 698, 879 A.2d 784 (2005), a claimant was admitted to Temple University Hospital (a provider) for work-related burns.
The provider billed the employer in the amount of $ 106,199.81, for the services furnished.
The employer responded by sending the provider two checks, totaling $ 34,156.34.
The employer also provided the provider with a review of the charges and the amount deemed to be reimbursable.
One year later, the provider submitted a bill to the employer's insurance carrier.
The insurer did not respond.
The provider then filed an application for fee review.
The insurer argued that the application for fee review was not timely.
The provider claimed that it was timely as the employer was not the responsible insurer.
Therefore, the statute of limitations did not begin to run until a bill was submitted to the insurer.
The Court rejected the provider's argument.
The Court stated that "for provider to argue that the time period did not begin to run until it sent insurer the bill ignores the fact that payment was in fact made to and accepted by provider and, in accordance with the Act, if it had a dispute as to the amount paid, it had 90 days after submission of the bill to file a petition." Temple, 873 A.2d at 782.