12
votes
Accepted
What is the duty of a medical office to properly bill one's insurance? (USA)
To my knowledge there is no actual law requiring a provider to file anything on your behalf. Most do it as a courtesy but if you read the terms of service that you almost certainly agreed to, it will ...
- 3,486
5
votes
Is a patient legally obligated to pay for non-emergency medical services that were not requested by the patient?
Presumably you consented to have an x-ray.
It is a reasonable assumption that it was not your intention to simply be given the films without interpretation by a radiologist. If that was your ...
- 227k
5
votes
I had work done on my dentures, but they did not tell me the work was not coved by my insurance
You are responsible for the charges. Dentists, doctors, etc. will file the charges with your insurance for you, but the insurance company decides what they will pay. The dentist would have no idea ...
- 308
4
votes
What is the duty of a medical office to properly bill one's insurance? (USA)
In terms of your contract with the doctor, there is probably no contractual obligation for the doctor to submit anything to the insurance company. You can read your contract (if you ask for it, though ...
- 217k
3
votes
Accepted
Can the US somehow "claw back" or otherwise recover some of the $35 billion in over-billing by a Singapore-based firm founded by a Malaysian national?
The U.S. government could sue the firm for fraud or unjust enrichment (and probably also claims arising under other statutes particular to defense contracting) since the allegation is that due to bid ...
- 240k
3
votes
What is the duty of a medical office to properly bill one's insurance? (USA)
This is the difference with 'in-network’
An 'in-network’ doctor has signed contracts with the insurance network - so they agree not only to bill on behalf of the client, but also settle for insurance ...
3
votes
Reimbursable hours: Reasonable Legal Expenses
The starting point of an analysis of reasonable fees is to calculated the "lodestar" which is a reasonable hourly rate times a reasonable number of billable hours devoted to the task.
A ...
- 240k
3
votes
Accepted
Online Service Requires 2-User Minimum Billing for Per-User Priced Product
A business is free to set its pricing model in whatever way it chooses, unless there is a specific law restring this. As no country or jurisdiction is mentioned in the question, there is no way to ...
- 115k
3
votes
Am I obligated to pursue an invoice?
Give the contract language now included in the question, it seems that payment is not due until after the invoice is submitted. I don't see any obligation on the homeowner's part to prompt the ...
- 115k
2
votes
Received Dental Bill From New Owner's After Previous Owner's Said I Owed Nothing- Can they continue to collect
In a written letter back to me the new company acknowledged that the original dental office had a policy of writing off any remaining balances after insurance payments, however, their practice does ...
- 7,699
2
votes
Am I obligated to pursue an invoice?
That depends on what is in the contract for the job, and on the state of the job.
If the agreement was that you would pay when the job was complete, you are obliged to do so (assuming that it now is ...
- 115k
2
votes
Can I be charged for dental services that were never provided?
Can I be charged for dental services that were never provided?
No. At this point the company's/dentist's delay of service is indicative that they are not planning on fulfilling their obligation ...
- 45.5k
2
votes
How to avoid unwarranted bills as a victim of online order fraud (with zalando)
How to protect myself from the upcoming unwarranted bills of the online shop?
At the outset, make sure you keep records/evidence of the events: your returning of the packages, your compliance with ...
- 45.5k
2
votes
Reimbursable hours: Reasonable Legal Expenses
The average hourly rate for legal services in Florida according to Statista was very close to 300 USD between 2020 and 2023. This does not reflect the price of any case though.
The Clio Legal Trends ...
- 45.2k
1
vote
How to avoid unwarranted bills as a victim of online order fraud (with zalando)
You can't protect yourself from getting a bill, although it's unlikely Zalando would pursue you without particular suspicious circumstances since the scam is relatively common. Reply to letters by ...
- 6,401
1
vote
What Is the Impact of Liability on Billing for Work Not Done?
What does the contract say?
Force majeure is not inherent in common law; it’s a civil law concept. However, it is not uncommon to refer to clauses in contracts that deal with eventualities beyond the ...
- 227k
1
vote
Is a patient legally obligated to pay for non-emergency medical services that were not requested by the patient?
You have the option to refuse to sign the financial responsibility paper, which is what obligates you to pay. They, of course, can then refuse to treat you. This is a matter of contract negotiation – ...
- 217k
1
vote
Handling a disputed invoice: verbal quotation
Should the recipient pay the undisputed amount in the mean time? Or does payment of the undisputed amount imply acceptance of the wider charges of the disputed invoice?
Timely payment of the ...
- 45.5k
1
vote
Handling a disputed invoice: verbal quotation
what recourse does the recipient of the invoice have to rectify the issue?
Why does the recipient need “recourse”? They have not at this point suffered loss needing recourse.
how can the recipient ...
- 227k
1
vote
Am I obligated to pursue an invoice?
Do I have any legal obligation to pursue this invoice? To call them and ask about it?
This sounds confusing. If the contractor "literally forgot to do part of the project", then the job is not done ...
- 45.5k
Only top scored, non community-wiki answers of a minimum length are eligible