When this first happened, I paid an online attorney for advice, thinking that the urologist did not have informed consent. I have copied part of his response.
First, I want to convey that I am on your side in this matter, and that renegade medical providers and obstinate insurance companies are two of my biggest pet peeves. That said, below are the facts, both good and bad. If I have misunderstood any part of the situation, I will be happy to reevaluate my response based on the correct information.
The beginning of your question mentioned a concern about application of this bill to your deductible ...
With regard to a business being "closed," such status does not, in most cases, prevent the collection of debt. This is the case because the entity may either not be fully dissolved, or it has assigned its right to payment to another business, such as a collection agency or debt buyer.
With regard to not receiving bills, you will not be able to rely on the non-receipt as a valid defense to payment. This is the case because, the way the law sees it, an obligation was incurred whether the patient is properly billed, or not. Additionally, allowing a defense on this basis would allow dishonest patients to claim they never received a bill and therefore don’t have to pay, and would also allow a defense if a person moves and does not leave a forwarding address. Obviously, neither applies to you, but that's the rationale the courts apply.
With regard to authorization - similar to the rationale in the last paragraph, the law will imply consent to the bill from the new provider by the fact that your husband presented for treatment with the originating provider. The law is unanimous in all states and extend consent to each and every "spoke" provider with whom the original provider contracts to provide services on behalf of the patient. Authorization is implied and not expressly required.
Quite unfortunately, it is not a medical provider's legal obligation to tell the patient what charges are in network in which charges are not, and this includes contract providers down the chain, such as the one that ended up with your slides. The law places the burden on the person who is insured to do the research, ask questions and find out, if that person has a concern. Therefore, disputing the bill based on not having been provided with this particular information does not trigger an informed consent issue and is neither legally valid, nor will it be accepted by the insurance company. Additionally, signing paperwork to authorize additional "spoke" providers, is unnecessary, as discussed, above.
That said, any provider who over bills, duplicate bills, or obligates the patient to a test not reasonably linked reasonable treatment for a particular condition, or tests conducted in disregard of the patient's express instructions to refrain from testing, and even the express instruction to refrain from particular sub-provider could be legally valid reasons for withholding payment.
AND
If the provider is one that normally bills the insurance, whether in or out of network, and that provider failed to do so within the time provided by the insurance company (usually one year) it cannot thereafter turn around and collect from you an amount that would otherwise have been available through insurance. In such a case, the negligent delay is the fault of the provider and you can be relieved of part or all of the obligation. The way this usually works is that the total bill is offset by the amount that would have been paid by the provider, and you would only be responsible for the amount the insurance company, itself, would have attributed as your portion of the payment.
With regard to your proposed letter, I believe I have touched on each of the facts you mentioned and explained the way the law, and the insurance company/provider will treat each one. I do not have access to the letter that lwpat provided to you, but he's a smart attorney. If lwpat had access to the same information you provided in your most recent question, and provided a letter for you to use, I would trust that the letter will provide you with much benefit.
I would also suggest taking the possibilities conveyed in my letter, and consider the extent to which each applies to you. If you find something applicable, you may want to incorporate it into your main correspondents and will certainly want to use it to maximize the potential benefit in this unfortunate and most frustrating situation.
What we did was the Better Business Bureau as I stated in earlier posts. This seems to be the best way to go. Hope my $30 purchase of advise helps others!