Medical Debt Violations? Need advice

[Anonymous]

I was informed of a medical bill placed in collections by Wellstar. They sent it to Medical Data Systems. I was unaware of this bill and was informed it was placed with MDS in December 2016. The bill is from an ER visit 3/17/14. Very long story short the hospital mailed the bill to an old address they had in their old billing system which was not correct. I know this because upon finding out about this debt I went home and went through all of my records and found the Provider bill from the ER visit addressed to my correct address. I called the hospital and they could not find the account. I explained they placed it with MDS and mailed info to an incorrect address. After speaking to 4 different billing reps noboby was able to locate it. I asked to speak with a supervisor and she was able to find it in their old system. I explained that they mailed it to the wronfg address and she argued. I told her I have proof in the form of my medical record being sent to another doctor the ER referred me to for follow up care. She said that doesnt matter because its not the hospital. I argued because it is a wellsar doctor in the same facility and my information was sent to him based on the ER visit. I also rstated that per the Wellstar website it states that all patients information from insurance, hospital, office visits, labs and all information Wellstar has for each patient is all located in one convenient location to prevent patients from having to repeat all of their information at every Wellstar office or appointment and that it also says each pateients information is all consolidated into one file to make billing and payments easier. I expalined I use mychart all the time and this account has never been reflected in any statements or summaries adn my account shows a 0 balance due. She tried to pull up the paperwork the patient signs at registration and before they discharge to prove me wrong but was unable to find any of it in their old and new system. She still refused to pull it from collections. The next day I sent a request for an itemized bill for these charges as I have no records.

Wllstar responds: We cannot locate that account in our system and the date 3.17.14 shows a $0 balance

I reply: This account was placed for collection and I need an itemized bill and again provide the account number, Provider name, location of ER and date of service

Wellstar responds:I'm sorry, but the information provided is not sufficient to locate the patient in our system. Can you please provide your social security number?

I respond with my social

Wellstar responds: your request has been received by the Wellstar Billing Department. Unfortunatley, I am unable to assist you with this account. Please contact Medical Data Systems. They will be able to assit you with this account.

I reply: MDS cannot provide me with an itemized bill of charges and services rendered. This would be a violation of patient privacy and violates the HIPPA laws.

Wellstar Responds:Your request has been received by the Wellstar Billing Department. We have noticed your address is listed differently in our billing systems. Please verify your address.

I replyed with my address which they have in their system and my address has been the same for the last 3 years

They have yet to reach out to me. My question is how can they send a debt for collections if they cannot locate the proper paperwork and also directing me to contact the CA for a itemized bill? That would give the CA access to my medical history which is a HIPPA violation. I was considering sending the CA a DV but all they legally have to provide is the date, amount and OC which they already have. Can anyone assist with input or advice on how to handle this matter? It has not reported on my Credit Report yet so Im trying to figure out what steps to take before it does.

[RobertEG]

What is your state of residence?

[Anonymous]

Georgia

[RobertEG]

Response to a DV under the federal FDCPA does not explicitly mandate documention to support validation.

Some states have enhanced debt validation statutes/regs that include itemization and documentation.

Georgia is not one of those states.

Under HIPAA, debt collectors have permissible purpose to obtain medical informormation, but are only permitted to retain sufficient details of medical debt to permit their collection on the debt.

It is arguable as to whether a DV request provides permissible purpose to obtain and thus provide details.

Certainly, itemization at the level of principal and additional interest could be provided without any details of the medical services or documentatin of the type of service.

Regardless, response to a DV is not mandated under the FDCPA, so they do not have to ever respond to a DV request.

If they cannot provide adequate validation, they could choose simply to continue to cease collection activities without any requirment to respond or to delete any credit reporting.

If you dont contest the debt per se, and the amount is the issue, then a compromise might be to offer them an amount that you consider to be appropriate as full satisfaction of the debt, thus putting aside all the controversy regarding details of itemization and documentation.

[Anonymous]

Thank you for your feedback. I have a couple of other questions. If the Hospital cannot locate the account or any documents pertaining to the bill in question can they authorize Medical Data Systems to collect?  I am trying to figure out my options since the amount MDS says I owe is about 20% of my income and they claim it has to be paid in full. If the hospital cannot locate the bill or provide me with any records I am at a loss as to how to verify this information. I am concerned because I have had quite a few medical visits over the last few years and I would like to make sure this is what MDS actually says it is. Especially since the hospital has stated they cannot find this account in their system and show no balance due on this month and the following monthly statements. I called MDS last week because of another account with them that insurance paid and the representative lied to me about the balance and also said insurance rejected the payment. I know that is false because I had already spoken to my insurance company and have the claim details. My insurance paid the claim and listed a patient responsiblity of 0. I explained this and the CA rep tried to tell me I owed the difference in what the hospital charged and what my insurance paid. I told her I was aware of my EOB and had already spoken to my insurance so I was aware that what she was telling me was not true. I understand CA's will say anything to try and collect and if the OC doesnt have the account and MDS collects on their behalf and does not own it I am confused on their authority to collect. Especially if Wellstar does not have a record of my signature authorizing release of my information necessary to secure payment.