How long does a health insurance company have to deny a claim?

My wife just got a notification from a doctor's office. A claim that was initially supposed to be paid by the insurance company in September of 2015 was just "transferred from insurance" in December of 2016. Now she is receiving bills for her services.

Is it legal for a health insurance company

My wife just got a notification from a doctor's office. A claim that was initially supposed to be paid by the insurance company in September of 2015 was just "transferred from insurance" in December of 2016. Now she is receiving bills for her services.

Is it legal for a health insurance company to just deny the claim after 15 months? It seems ridiculous to me. I will be calling them on Monday and want to know what grounds I have to stand on.

Other answer:

jesse c:
You have no grounds. Maybe the doctor's office didn't bill until the services were completed, months or a year later. Even if they did right away. The insurance company has forever to accept or deny coverage. If you wanted to know in advance, you should have called and asked or read the policy to see if the service was covered. She had the procedure so, she owes the bill.
Insurance Pickle.com:
Depends on who dropped the ball. If you dropped the ball, then no grounds. If the doctor dropped the ball, then I wouldn't pay the doctor any more than if the insurance paid. Hard to otherwise say without knowing facts, because one would assume the insurance company wouldn't just not be processing it unless they now just got information they'd been waiting on.
A Hunch:
You should be able to log into your insurance account and see the status of the claim.

My guess.
The doctor filed the claim with insurance. They didn't bill you during this time.
The claim was rejected and the doctors billing office handled the appeals process for you.
The claim went through the entire appeals process and was never accepted.
The billing office then billed you.

Elaine M:
You can also contest their decision and require them to tell you which doctor turned the claim down (most claims are turned down by the data input people not the doctors).

A patient's bill of rights — check this.
https://www.whitehouse.gov/files/documen…

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Judy:
Yes.
Donald B:
If you owe it then it is legal.
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