Am I responsible for a medical insurance bill due to an expired referral?
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Am I responsible for a medical insurance bill due to an expired referral?
Last summer I had a biopsy preformed by my urologist, my insurance rejected payment because my referral had expired. Is the doctor performing a procedure required to get a pre-authorization before a
procedure? Does my primary doctor bear responsibility? Am I responsible for this bill?
Asked on April 18, 2019 under Insurance Law, Maryland
Answers:
SJZ, Member, New York Bar / FreeAdvice Contributing Attorney
Answered 5 years ago | Contributor
You are responsible. It is YOUR medical insurance--it is your obligation, not the doctor's, to make sure you have the coverage for the procedure that you think you do. And you are responsible to pay--either through your insurance or, if insurance does not cover, out of pocket--the costs for the procedures you have done or medical care you receive. So if your referal had expired, it is unfortunately your responsibility, and therefore your responsibility to pay for the procedure since the insurance will not.
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