Since they're out of network, then unfortunately there's no agreement between the insurance company and the provider. However, state laws may obtain for the timely submittal and processing of medical claims. It's still possible the provider could be beyond a statutory limit.
I'd gather up all the info and paperwork you have, then give the insurance company a call. They'll want to know the dates of service, name of the patient, SSNs, address at the time, etc. You might get bounced between a couple of folks until you find the right person. Remain patient. Older claims might be archived, moved to the responsibility of a different group, et al.
Appear lost and in need of help.
Hi, um, ah, I'm calling about some, er, information on some medical claims. But I'm not sure who to talk to, um, can you help me?
If you appear lost and in need of help, people have an instinct to help, and they might possibly volunteer more helpful and useful information than they might otherwise volunteer.
Once you're talking to someone about the dates of service and claims, tell them the doctor's office sent the bill to a CA and you wanted to try and find out whatever details you can about the claim, when it was submitted, did the claim get rejected, etc. The doctor's office may not have coded something correctly or may not have responded to the insurance company when they asked for more information.
Sometimes insurance companies will volunteer to call the doctor's office on your behalf. Let them. When the insurance company comes calling, particularly if the provider screwed up, the provider tends to take notice and act to rectify the situation.
