Is my mother's estate being scammed?

May 8, 2008 6:10 PM

Medical insurance paperwork still coming in 9 months after my mother passed away.

My mother passed away when she was living in a nursing home the end of September 2007. Ever since then I have been receiving explanation of benefits letters from Blue Cross/Blue Shield and Medicare. I can certainly understand bills for the date she was rushed to the emergency room, and for some a month or two prior that had just been working their way through the system.

But I am still getting bills from dates prior to the date she died. How do I know if this is fraud? Who would remember what was or was not done that long ago, and obviously the patient cannot be asked. It seems unlikely an xray lab or psychiatrist could take 9 or 10 months to get around to submitting a bill. The whole thing seems fishy.

Up until now it has been academic because the bills showed nothing due from the estate. The last couple amount to a few hundred dollars supposedly being owed, and are from August 2007.

Has anyone else run into this with their deceased loved ones? I tried doing the following MeFi search and did not see anything that sounded like my situation: "deceased bills insurance nursing home".

Has anyone ever complained and if so, to whom?

Thanks in advance for any advice. As you can imagine this is a little more emotional than your average unexpected mail, since it brings me back to a time I was trying to get over.

posted by forthright to law & government (8 comments total)

Why not just call up BCBS or Medicare and ask? I'm sure you can find 800 numbers for them on the net. To be sure it's not a scam, I would *not* call the 800 numbers on the bills you received.
posted by All.star at 6:47 PM on May 8

It often takes many weeks to months for bills like this to be processed.

I would not call Blue Cross. I would call the providers and ask for documentation of the dates and the services involved. An honest provider will not hestitate to provide this information, assuming that you establish (with your letters of authority) your standing to make the inquiry.
posted by yclipse at 7:23 PM on May 8

A friend of mine works for a chiropractor that does regular work accepting coverage from a large insurance provider. This friend recently broke his leg and was relegated to office duty reviewing their billing. He found many bills 6+ months old that hadn't been sent to the insurance company for reimbursement and apparently they could still be submitted.

Ultimately what I'm getting at is that it wouldn't surprise me one bit that bills sit around at doctors offices for some time before being submitted.
posted by Octoparrot at 7:52 PM on May 8

I gave birth over five months ago and I'm still getting some of the bills.
posted by Asparagirl at 8:40 PM on May 8

I appreciate all your responses. I just wanted a sense of what to expect and what the odds were that this is normal. As I said, I don't relish making the calls because of the memories.

Thanks.
posted by forthright at 9:45 PM on May 8

My wife had knee surgery a while back, followed up with a couple months' physical therapy. The hospital somehow split the charges between two billing accounts, and two other independent companies did the PT. Bills trickled in for nearly a year. Fortunately I'd kept a folder of bills so I could match them up to EOBs and account for which had been paid and which hadn't. I did find some errors -- a couple of small charges that had been incorrectly denied, and one substantial service that was billed a second time, after it had been paid, but none of it seemed like fraud. It's just a cumbersome system, and things take a while to work their way through.
posted by jon1270 at 2:49 AM on May 9

Sorry for your loss, BTW.
posted by jon1270 at 2:50 AM on May 9

Be sure to check the insurance policies. Many of them will not accept a claim after a specified amount of time. Most likely, it's a 12 month limit. As others have stated, it can take a long time for the bills to trickle in, and it's a difficult thing to keep straight. I empathize with the difficult emotions this triggers.

My condolences. It's hard enough to deal with the loss, and the bills can bring those emotions back to the forefront. If you can find a friend to help with some of this, that may be an option to lessen your burden. Good friends are often looking for a way to help...
posted by mightshould at 5:52 AM on May 9