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Insurance info leads to billing woes

DEAR DR. GOTT: My husband recently received a collection letter for a doctor bill that is almost three years old. I tried calling the office but could only leave a voice-mail message. In the meantime, I found an e-mail address and requested they contact me.

A few days later, I got a phone call and was told they did not have any insurance information on file. I gave the woman what was required, and she said she would file it but thought it would be denied because the bill was so old.

Later that day, I received an e-mail stating the claim was originally filed as a workers'-compensation case but was denied. They then filed with Blue Cross Blue Shield (BCBS). Supposedly, they didn't get a reply.

To give a brief background, my husband went to the emergency room in April 2005 by ambulance. Looking back in the records, I saw the hospital and ambulance both filed with BCBS and were paid. I really don't know why the doctor is saying they have it as a workers'-comp case. I called BCBS, which said if the doctor produces the paperwork and the claim was denied by comp, they would process it. The doctor's office is now being very rude, just saying it is in collection and there is nothing they can do.

We are very angry. We have excellent credit, and now they are trying to ruin it. Can you offer some advice on how to handle this? I know we can pay it, but that is what we have insurance for. Please help.

DEAR READER: The only piece of the puzzle I see missing is why your husband was sent to the emergency room via ambulance. Was he injured while working, or was he retired at the time? It may have been difficult for the physician to obtain the correct insurance information in an ER setting. Who provided the workers'-compensation information to the doctor at the base of all this?

It's my guess his office staff filed the claim and were directed by what appeared on the ER sheet sent to the office. However, if it had been done in a timely manner, they would have had adequate time to file a second time with BCBS once the comp denial was received. If the second carrier also denied the claim, then you should have been contacted. As a general rule, a physician has 18 months in which to file a claim. Thus, I feel the fault lies with the office personnel. I'm unsure if they can legally write off the charge at this stage, but I would think that if the information you provided is correct, they should work out an amicable arrangement of resolution.

Try a cordial but firm note with a copy to the collection agency. Send it certified, return receipt requested so you have a record. Then sit back and see what happens.

DEAR DR. GOTT: I read your article on seborrheic dermatitis that is similar to cradle cap. The cure is petroleum jelly applied for 12 to 24 hours.

DEAR READER: Thanks for the simple tip. To provide related information, I am sending you a copy of my Health Report "Dermatitis, Psoriasis and Eczema." Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a check or money order for $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dr. Peter Gott is a retired physician and the author of the book "Dr. Gott's No Flour, No Sugar Diet," available at most chain and independent bookstores, and the recently published "Dr. Gott's No Flour, No Sugar Cookbook."