Medical Collections...Feedback On How Your Office/Facility Handles Them

[fused]

I have been employed in the healthcare industry (work for a surgical practice) for more than eight years and have extensive experience with bad accounts with patients as well as insurance companies. I have done my very best to refrain from posting on med collections but now I feel the need to as I'm a bit concerned with some of the advice being offered up in the forums. This is not say all of the advice has been bad. I have been working diligently on a thread (draft) to help those who have unpaid and paid collections and judgments. I have spent a great deal of time talking with others who handle bad accounts in providers offices and facilities and have discovered there is absolutely no consensus among either of them on how they handle bad accounts.

I am asking for some feedback from those of you who work for a provider or facility and your primary job is billing and handling bad accounts. What are the protocols for the provider or facility who employ you? Are collections handled in house, assigned to a CA, sold to a CA, written off or something else. How about suing? Have you ever had a patient write you or your employer a GW letter or ask for a PFD? If yes, what is your or your office's policy? Do they consider deleting? If you are allowed to delete, does your employer give you this discretion? It's my hope to have a new thread offering guidelines on how to best handle med collections and judgments pinned at the top of the general forums in the not so distant future.

[Anonymous]

While I don't work in the field, first line of attack IMHO is to contact one's health insurance company--assuming one had coverage at the time of the incurred charge. Even if it was from several years ago, if it's within the CRTP (or SOL in most states) then odds are good the insurance company will have docs. They are incredible record keepers.

FCRA and FDCPA violations are subject to the opinion of a judge, but a provider violating the rules of an insurance company doesn't have such protections or vagueness in the law. When the insurance company speaks, providers listen and act.

Anecdotally speaking, from talking to folks, a great many medical collections come about because the provider failed to fill in a box on a paper form correctly, filled it in with something the insurance company could not decipher, or the provider failed to respond to the insurance company's request for more info.

If the provider was in network, they will sometimes try to bill for charges the network plan will not PERMIT the provider to bill. I know this from personal experience. Happened to me several times in recent years. I've had to get on the phone to the insurance company, ask about the claim, the charges, what was paid, what was denied, and of what portion am I responsible. While sometimes appearing to be a little cold and clinical, I have always had good experience when I call. They give me the details I ask about.

Sometimes I've taken what I learned, called the provider, and problem fixed. A few times, the insurance company rep has offered to call and talk to the provider directly. I think I had 'em do that once or twice, but I try to handle it myself with the provider so as to try and keep on friendly terms with the provider.

Have ready the date of service, name of the provider, SSN and name of the insured, SSN and name of the patient (although SSN might not be needed). Also DOBs for both the patient and the insured.