Surprise Medical Bill Collection - What To Do?

[wils70]

Hi there.

Am trying to figure out best course of action. I had a medical procedure last year back in August that hit my credit report today as a collection. I have (now, past tense) excellent credit before this (800+ scores across all three agencies). I have never received a single bill for the apparent out of pocket amount - not as much as an invoice, 30/90/120 late statement. I had even checked my online hospital account over the months to make sure nothing was outstanding and this never showed up (and still doesn't).

Of course, the hospital billing department isn't returning voicemails.

What is the best plan of action to get this rectified? I truly had nil idea I owed anything and again have had nil notifications from the medical facility that any additional money was owed beyond what insurance paid and other bills I paid tied to the same procedure. I need to get this off my credit report and am seeking advice on best way to proceed.

Thank you!

[RobertEG]

If the debt is legit:

1. Pursue getting it paid via your insurance.  If paid by insurance, it will be removed by the CRA on its own under their National Consumer Assistance Plan.

2. Offer the debt collector a PFD.

If you wish to contest the debt:

File either a dispute, if you have basis to contest the debt, or file a DV request to begin the process of contesting the debt.

If you live in NY, Mass, TX, or Calif, you should consider a DV under their enhanced statute/reg.

[DaveInAZ]

Well, the first thing to do is dipute this with the CRAs, they will make the entity filing the collections verify the amount & that you are personally responsible for it. Hospitals & medical service providers usually don't file collections, they turn unpaid bills over to collection agencies who file the collection

When you say "out of pocket expense" I'm assuming you had insurance? The should have sent you an EOB, Explanation of Benefits, that would detail how much the hospital billed, how much they allowed*, how much they paid, and how much was you are responsible for. ("Allowed" - medical service providers bill at "full retail rate", and insurance adjust that down to their contracted rate.  

The bill from the hospital should also detail that, strange you never got a bill. Strange, and suspicious - not you, the collections.

[wils70]

Thank you.  I have gone through my insurance claims from last year and see that they were indeed billed and paid what they owed.   However, no bills were ever received for any additional amount from the medical facility or on behalf of.  I am completely positive I didn't recall seeing any but have gone through my historical paper medical statements and in indeed there are none.  They simply never came.  Seems like the hospital (well at least this department/branch) have their billing handled through a third party.  Looks like this third party handed over to a CA.  The hospital definitely has my correct mailing address but possibly the third party didn't...  Seems like a stretch though.  I am happy to pay any amount outstanding if it's legitimate but am not willing to just accept letting this sit on my credit report.  My score literally dropped 111 points as result.  Am livid.   Question though - if it was a legitimate outstanding amount but having never received any notification of any amount due from the biller, can you dispute that?    Can the third party biller pull it back from collections or is done and dusted now it's gone to CA and have to deal with those guys?  Thanks again for to everybody for any and all advice given.

[RobertEG]

Regular billing is only required federally under the Fair Credit Billing Act (FCBA) on revolving accounts, as the balance changes monthly.

However, installment and due when billed types of credit do not have a formal requirment for regular billing, as the payment due and its amount is fixed in the contract/agreement that created the debt.

There might be a state statute or reg that applies to some requirement for explicit billing before they can legitimately report delinquency in payment to a CRA, but that would be peculiar to your state, and would require some research in order to assert that their lack of billing was basis for precluding their reporting of a delinquency.

You might contact your state office of consumer affairs for their advice/opinion.

[wils70]

Sorry, to clarify -  is this basically saying they were under no obligation to inform me how much was owed, if anything?  How would I ever possibly know?  I didn't even know "XXX XXX Pathology Services" existed until today.  Thank you.

[wils70]

Yes, I had/have insurance.  I tracked down the specific EOB online and see a "You May Owe" amount which matches this. However, it also explicity states "This Is Not A Bill" and in 100% of my other medical expenses thus far, I've received a subsequent statement and/or bill (which I've immediately paid).  I just don't think this particular bill was ever sent in any form, even once.  Am a bit confused now as to whether they're required to or not (if not, not sure how one would ever be expected to know what is owed)?  

[RobertEG]

I am not stating that there is no requriment for billing.

I am only saying that the only mandatory subsequent billing requirement in order to then report to a CRA applies only to revolving credit under the FCBA.

I am advising to contact your state consumer agency that regulates such mattters, and inquire as to any state statutory or regulatory requirments.

[wils70]

Thanks.  Am leaving twice daily voices to both the hospital and third party biller.  I haven't heard from the CA yet but I guess I will start with certified letters to both the hospital office and third party biller as well as dispute the item on both credit reports (so far, not shown up on the third).  Also looking into Consumer Finance Protection Bureau as well as the state equivalent. My SO is an expert litigator (by profession) so we will fight this as it's completely unjust.  Thanks again.