medical debt collector

[Anonymous]

so for starters i have excellent credit (recently 748 EQ).  i also have excellent insurance and recently changed doctors and went in because of minor heart palpitations.  the doctor had blood work done and the blood work company sent me a bill.  the doctor also sent me a bill, on top of my copay.  this has never happened to me before.  it was a small amount of $50, but still irritating and confusing.

i called the doctor and they said the insurance deductible wasn't enough to pay for all of the doctor's services.  never has this happened to me before.  i looked it up on the internet and read this is a pretty common practice of medical providers, though most of the time the explanation is not valid and neither is the due amount.  when i called the person on the line said that they would send me 3 bills and then decide if they wanted to pursue the outstanding amount before they went to a debt collector.  this made me certain this was an illegitimate fee that i owed them and that i probably didn't really have to pay it, they just wanted more money from me.

i get a 2nd bill, ignore it.  then out of nowhere i get a debt collector's bill.  i never got a 3rd bill as they indicated.  so i pay it, even though i still feel rather confident i wasn't supposed to have.  i got the debt collector's notice on 9/26 and applied to a car loan on 10/12 and got a 2.49% APR, which is the lowest the lender can go.  i paid the debt collector on 10/15.  is it possible they never reported me to the credit bureaus or just haven't yet?  i would think if they had, i would not get the low car APR, right? if they do report it, how much will it affect my score?  i really hope not a lot at only a $50 premium i owe.  is there anything else i can do about this?  i feel like it all was a little shady on their part, especially never getting the third bill, even if i didn't pay it on time.  any help is greatly appreciated.

[Anonymous]

edit: the practice is called "balance billing" as seen here in business week.  the doctor's office also said they would call me again to remind me to pay before they went to a debt collector, if the specific doctor decided to continue to pursue the payment after 3 bills.  again, never got 3 bills and definitely never got the call saying they were proceeding to a debt collector.  here is the article on balance billing:

http://www.businessweek.com/magazine/content/08_36/b4098040915634.htm

[Booner72]

I'm pretty sure you don't have a recent collection and still get approved for 2.9% APR.  Sometimes if you pay right away they don't report - What I've read and experienced is that CA's for medical providers give you a month to pay b4 they report.

[IOBA]

I receive a statement from my insurance company that clearly spells out what I have to pay.

If the doctor wants more, (over and beyond what my insurance company says I have to pay) I remind them of the agreement.  If they don't back down, I call the insurance company.   They have special investigators to handle these types of situations.   The insurance company can go to bat with you.  I didn't know this until I experienced one of those types of situations (oh, you still owes us what the insurance company didn't pay...I dont' care that they said you owe $20, you signed the form that said you would be responsible for the full bill regardless of what insurance says...now pay us the other $450 now!)   Called the insurance company.   

For me, it was the end of the story.   Dr backed off.

[Booner72]

IOBA--- IMO, that only works if the doctor is a 'preferred provider' or in some kind of contract w/ the insurance co. 

[IOBA]

Yes and no.  

Regardless of whether the provider is preferred or not, the insurance company sends me a statement that says how much I have to pay the provider.   I go by  what the insurance company says, not what the provider says.

For example, (I am making up these numbers) Dr B charges me $2555 for a procedure.   He's preferred and bills my insurance company.  My insurance company issues a statement to both of us (Dr B and I) that says

$2555 for procedure

$815.15 allowed

$1596 NOT allowed, per contract

$143.85 patient responsibility

Ok, I pay $143.85 because my insurance company said so.

Say Dr C is NOT a preferred provider.   He bills my insurance company for the procedure.  My insurance company issues a statement to both of us (Dr C and I) that says

$2555 for procedure

$815.15 allowed for procedure

$1596 NOT allowed

$570.60 payment made by insurance company

$244.55 owed (30% copay for non preferred provider) patient responsibility

$1984.40 total due to the provider  ($2555-570.60 paid for by insurance company)

Ok, I pay $1984.40 because my insurance company said so.   (With a high balance like that, I would most likely ask the dr to discount the balance due.   They usually will.)

I have had dr's collect the insurance money and then bill me for the full $2555 and expect me to pay it ALL.  Whether they are preferred or not, that is just wrong.