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My cardiologist's office told me that they were in networ...

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My cardiologist's office told me that they were in networ...

 
Message 1 of 14
13 REPLIES
Senior Contributor

Re: My cardiologist's office told me that they were in networ...

Always confirm with the insurance company. Providers often get it wrong. There are a myriad of insurance companies and plans. I know from experience there are tons of Delta Dentals. Not quite one per state, but close.

If it ain't in writing, then it didn't happen.

You could also get countersued and/or have to pay their legal expenses. If you don't have some basis for the lawsuit, why gamble with court? And court is a gamble.

Medical collections might be a PITA, but in this case it has nothing to do with completion of the payment process, by which I presume you mean claims processing.

Did you get the EOB from insurance? Did you go over it? Did you call your insurance company and go over the EOB with them?

If IC Systems is abusive or harassing you, consider recording the calls.
http://ficoforums.myfico.com/fico/board/message?board.id=generalcredit&message.id=21764

If you're in a One Party Notification state, then it should be a breeze to catch 'em in violation on tape. Catch 'em several times. If you have a rock solid FDCPA violation, that should be more than adequate to get them believing it's easier to delete than go to court and lose.
Message 2 of 14
Regular Contributor

Re: My cardiologist's office told me that they were in networ...

I had the same problem. I was socked with $1,000 bill after the hospital told me some services were covered but were not. It took me 18 months to get billed, and I was billed by receiving a letter from the collection agency. I yelled and yelled at the Hospital. They could have told me there was a problem with billing 15 months prior and I would have taken care of it. I had no other options except pay the bill. That is where my tax refund went. So much for a vacation that year..
Message 3 of 14
Regular Contributor

Re: My cardiologist's office told me that they were in networ...

My quick question.. If you live in a two party notification state.. You call the collection agency or creditor. On the company's phone system you hear the message "the call may or will be recorded." Does that make it legal for you to record the phone call?


Message Edited by Pants on 07-19-2007 03:43 AM
Message 4 of 14
Moderator Emeritus

Re: My cardiologist's office told me that they were in networ...

I my non-legal opinion: yes
 
Be sure to record that portion as well.

Pants wrote:
My quick question.. If you live in a two party notification state.. You call the collection agency or creditor. On the company's phone system you hear the message "the call may or will be recorded." Does that make it legal for you to record the phone call?


Message Edited by Pants on 07-19-2007 03:43 AM


Message 5 of 14
Senior Contributor

Re: My cardiologist's office told me that they were in networ...



Pants wrote:
My quick question.. If you live in a two party notification state.. You call the collection agency or creditor. On the company's phone system you hear the message "the call may or will be recorded." Does that make it legal for you to record the phone call?


I think it's going to depend on the state and the specific wording in the statutes. For example, let's presume the statutes read in part, "When a party to a telephone records a call, the party recording the call shall notify all parties involved in the call."
 
In English, if you're recording, you have to tell everyone. Not simply a case of some notification having to occur, but specific notification.
 
Message 6 of 14
Senior Contributor

Re: My cardiologist's office told me that they were in networ...



Pants wrote:
I was socked with $1,000 bill after the hospital told me some services were covered but were not. It took me 18 months to get billed, and I was billed by receiving a letter from the collection agency.

Medical billing and collections is an area desperately in need of legislative reform.
 
15 USC 1681s-2(a)(7) requires "and financial institution that extends credit" to notify the consumer within 30 days of reporting the adverse info to the CRAs. Notices in cardholder agreements and the like are NOT adequate.
 
 
The Fed has weighed in on this one as well.
 
 
A financial institution generally may provide the notice about furnishing negative information on or with any notice of default, any billing statement, or any other materials provided to the customer, so long as the notice is clear and conspicuous. Section 217 specifically provides, however, that the notice may not be included in the initial disclosures provided under section 127(a) of the Truth in Lending Act (15 U.S.C. 1637(a)).
...
These groups suggested that the Board require the disclosure to be on the front page of the notice or billing statement, and require it to be in bold face type and in larger print than the information that accompanies it. The Board notes that section 217 requires financial institution to provide the notice of furnishing negative information in a clear and conspicuous manner.
 
Given the overall vagueness in medical billing, I think providers should be required to notify BEFORE reporting to the CRAs.
 
CCs, car loans, mortgages, et al. all have an affirmative, stated due date. Some provide a grace period, although I frankly don't see how a CCC could report one as 30 days late to the CRAs until one truly was 30 days late. Grace period my a**! Hows about complying with the freakin' letter of the late. If the CC due date is the 25th of the month, then it ain't 30 days late until the 25th of the NEXT month. Secondary rant over.
 
No such luck with medical billing. Due date, schmue date. They send it to collections when they danged well please. Primary rant over.
 
Message 7 of 14
Valued Contributor

Re: My cardiologist's office told me that they were in networ...

Going forward, if anyone ever has anything scheduled with either a Dr. or a Dentist and you are unsure of what is and what is not covered, have the Dr.'s office send over to your insurance company of what is scheduled to take place.  The insurance company will notify you of what is or what is not covered so there isn't any surprises come that day.
Message 8 of 14
Established Contributor

Re: My cardiologist's office told me that they were in networ...

I got a medical collection in March 2007. This was for my ER visit in May 2000. I NEVER ever received a single bill asking for payment. I never even knew anything about it. It is on my report for another 7 years now because the collection agency won't remove it.
Message 9 of 14
Senior Contributor

Re: My cardiologist's office told me that they were in networ...



Irvin wrote:
I got a medical collection in March 2007. This was for my ER visit in May 2000. I NEVER ever received a single bill asking for payment. I never even knew anything about it. It is on my report for another 7 years now because the collection agency won't remove it.


That's B.S. and you need to call 'em on it. Call the CRA and ask them for the DOFD. Is it paid or unpaid? If the ER visit is from May 2000, then there's no way I can see a DOFD of anything other than some time in 2000. They cannot claim a DOFD of 2007.
 
Message 10 of 14