Medical Collections and... HIPAA

[Anonymous]

I recently attended a LEARN ABOUT YOUR FICO seminar and the speaker had said something about HIPPA, the Health Insurance Portability and Accountability Act, enacted by congress in 1996. First of all, I have some medical collections so I was interested in what she said. What she said was to the effect that 'when you have a medical account and received medical attention, there is a breach of trust made when the hospital or doctor sends private information about you, the client, to a collection agency.' Am I way off on this one? It seems to make sense in regards to client/patient privacy, sort of like the attorney/client privelege. Does any one have some solid insight for me? She even said that there is some class action activity around the country dues to this breach. It doesn't seem like a doctor would send a collection agency anything more than a bill.

[Tuscani]

This is an overview of Why Chat's HIPAA letter process in dealing with medical OC's, CA's and CRA's.

Be sure to opt out and to update your personal information with the CRA's before doing any credit repair.

If using the HIPAA letters, do not have any contact with the CA(s)

If you have already contacted the CA with a DV or anything OTHER than a PAYMENT, you may still use the HIPAA letter program, however you must STOP responding to ANY CA communication. If you have PAID the CA, you can NOT use the HIPAA letter program.

If you have a CA listing on your reports, send the CRA Pre-HIPAA Letter Medical Dispute to the CRA's concerning the CA's TL. It is located at the very bottom of the HIPAA page

If this was to be paid by insurance and was not:

You should contact the insurance company to find out if or when the medical provider submitted the bill.
If they had submitted their bill in a timely manner, correctly etc.
If they had not been paid, why.
If it was denied because of the doctors office screw up, ask the insurance companies if the medical provider can refile for insurance payment.

Request the insurance companies send you, in writing, the reason it was not paid and if they will or will not allow the medical provider to re-file.

I would recommend writing to the medical provider and requesting a "full" accounting of your account. Also, request the date they had submitted the bill to the insurance company, and if it was denied, the reason the insurance gave them. Request a copy of the denial letter that the medical provider recieved from the insurance company.

If the OC health care provider tells you to contact the CA, DO NOT DO SO, follow the HIPAA letter program

The HIPAA letter program is not applicable if the account is valid and you are unable to pay it.

It will only work if the claim is either inaccurate, or you remit the valid correct amount due with the letter

If the debt is valid and you had no insurance at the time of service, or it is from the deductible from your insurance:

Send the HIPAA letter using [insert a ] along with your payment.

If you had insurance and the medical provider failed to submit a bill to insurance in a timely or correct manner, and the insurance provider will not allow the medical provider to re-file. Or is from a billing error:

Send the HIPAA letter using [insert b ]

If is not your account:

Send the HIPAA letter using [insert c ]


I strongly recommend that you follow all of the steps Why Chat has listed, and also, be sure to utilize all of the follow-up letters.

If you follow ALL the program letters and procedures and you are unable to resolve the problem, you then must file a complaint with the OCR on the HIPAA violations. If you must do so, follow ALL the directions and include copies of ALL your documentation including the "courtesy letter".*

Again - This is just an overview. Please read Why Chat's HIPAA page thoroughly before sending any letters.

Message Edited by fused on 08-19-2008 02:31 PM

[Anonymous]

Just wondering if these letters would help in my situation (I did read them, but am not sure if I fully understand). 

I had two late medical accounts last year while going through a divorce.  I paid the medical providers the full amounts due; however, after my payments were made, I found that the accounts had already been turned over to collections as "charge offs".  The accounts showed as "paid after charge off" when I checked my credit report. 

[Anonymous]

Yes, you can use them.  Go over to the rebuilding forum and at the top there is a sticky on the hipaa process.  You start with letter 1 to the CRA.   Good luck!!!

[Anonymous]

Thank you for the quick reply "love2golf".  I wonder if I should change the wording to ask them to send me the information provided to them at the time of the charge off - so that I am not actually providing permission for them to acquire information at this time (as far as Hipaa is concerned).  Any thoughts?

[fused]

There is a common misconception that paying or DVing a CA for a med collection will land you in hot water, this is NOT true. You do NOT lose your protection under HIPAA when paying or DVing a CA. DVing a CA is tricky and I would only advise doing so if you are unable to PIF the collection (usually hospital collections) or it's truly not yours. It's always best to work with the OC and use the HIPAA letter process.

[Anonymous]

Thanks for your time in helping me to gain a greater understanding.

The bills were paid in full by me (checks cashed) before I knew that the debts were turned over to collections as charge offs.  Am I understanding correctly that I should send the OC the Hipaa letter and refrain from any correspondance with the CA of record?  Just want to make sure I do this right.

Thanks again.

GeorgiaGal57

[fused]

Is the CA reporting this as a CO or collection? And, is this for a doctor or hospital debt?