If my doctor submits a claim too late and it is denied, am I still responsible?

September 20, 2009 by admin

Providers are mandated to submit claims to Medicare on their patient's behalf. Although providers have between 15-27 months to submit a claim for reimbursement based on the date of service, sometimes a claim is not submitted timely and not considered for payment by Medicare. However, you are still responsible for the 20% coinsurance amount based on what Medicare would have allowed for the service had it not been submitted late. Your Medicare Summary Notice will inform you of the amount you are responsible to pay your provider.