topic Re: Hidden Medical Debt Trips Up Homeowners in Credit in the News

Hidden Medical Debt Trips Up Homeowners

Lel — Sat, 11 Dec 2010 15:52:43 GMT

From the Wall Street Journal

Re: Hidden Medical Debt Trips Up Homeowners

marty56 — Sun, 12 Dec 2010 12:25:19 GMT

While I do not support a government takeover of medical care, I would love to see government regulation on medical billing. Unbundling should be illegal and all medical costs should definned clearly upfront.

Re: Hidden Medical Debt Trips Up Homeowners

Anonymous — Sun, 12 Dec 2010 19:14:14 GMT

I don't know why the industry doesn't do it on their own. It might be some contract with the CRAs or something. If there is nothing stoping them they are stupid for not doing it themselves. I have a $117 medical debt that I would pay right now if they would remove it. Because they will not remove it I will just wait another year to have it just drop off. I think the collection companies will make tons of money if this bill passes. Atleast in the first 6 months.

Re: Hidden Medical Debt Trips Up Homeowners

haulingthescoreup — Tue, 14 Dec 2010 00:14:27 GMT

@marty56 wrote:
While I do not support a government takeover of medical care, I would love to see government regulation on medical billing. Unbundling should be illegal and all medical costs should definned clearly upfront.

* scratches head * Where did you see a reference to unbundling?

If you're talking about unbundling in medical billing (billing for the separate components of a procedure when there is a single code that covers it all), it is illegal. If it's for Medicare, etc., it's Medicare fraud and abuse, and that can mean jail time. Think Inspector General visits.

My profession combines a complete lack of glamour with some scary consequences for screwing up! (I'm a coder, not a biller. It's the coders who have to make sure that there are no unbundled codes.)

Re: Hidden Medical Debt Trips Up Homeowners

marty56 — Tue, 14 Dec 2010 18:10:35 GMT

@haulingthescoreup wrote:

If you're talking about unbundling in medical billing (billing for the separate components of a procedure when there is a single code that covers it all), it is illegal. If it's for Medicare, etc., it's Medicare fraud and abuse, and that can mean jail time. Think Inspector General visits.

Several years ago I had a procedure where the billing company tried to unbundle part of a procedure that I had. They tried to bill me for the difference and since the doctor was a PPO, I told them to contact my insurance company which they never did and believe me I still look at my credit report to make sure the billing company doesn't try to sneek in a collection. IMHO they new it was illegal but took a shot in getting me to pay.

We have seen collection companies try to collect debt from people that were not obligated to pay (other family members) and I am sure that there are some billing compaies that also do this.

Re: Hidden Medical Debt Trips Up Homeowners

haulingthescoreup — Tue, 14 Dec 2010 18:36:14 GMT

@marty56 wrote:
@haulingthescoreup wrote:

If you're talking about unbundling in medical billing (billing for the separate components of a procedure when there is a single code that covers it all), it is illegal. If it's for Medicare, etc., it's Medicare fraud and abuse, and that can mean jail time. Think Inspector General visits.
Several years ago I had a procedure where the billing company tried to unbundle part of a procedure that I had. They tried to bill me for the difference and since the doctor was a PPO, I told them to contact my insurance company which they never did and believe me I still look at my credit report to make sure the billing company doesn't try to sneek in a collection. IMHO they new it was illegal but took a shot in getting me to pay.

We have seen collection companies try to collect debt from people that were not obligated to pay (other family members) and I am sure that there are some billing compaies that also do this.

Yes, they definitely do try, but if they have any sense at all, they won't try very long. Does your insurance company realize what the doctor's office tried to do? They're the ones with the ammo.

It's also easy to accidentally unbundle. For instance, maybe your doctor is removing a growth from your skin. Some excisions include sewing things back up; others don't; and some vary according to how complex the sewing-back-up procedure is. You have to know which is which, and the code books don't tell you everything. Good coding software is essential to prevent accidental unbundling, because the logic can be screwy.

(Alert: don't read below if you're not comfortable with medical stuff!)

For instance, if a patient has an EGD (tube with camera sent down via the mouth all the way into the beginning of the small intestine) and a colonoscopy (tube with camera sent upwards via the rectum through the colon to the end of the small intestine) on the same day, perhaps to check for a cause of chronic anemia, they have to be coded in a way that points out that they were separate procedures. In other words, the doctor didn't start out with the EGD and keep going and going and going through an additional 20+ feet of small intestine to then do the colonoscopy. A "modifier" needs to be attached to one of the procedure codes to point out that yes, these were two separate actions. (Duh!) Otherwise, they payer would try to bundle them together and only pay for one. Then you get a bill for the second procedure. This is an example of improper bundling, not unbundling, of procedure codes.

Sorry for the graphic example. It's just the classic example of weirdness in procedural coding and the sort of thing that makes coders occasionally twirl around in our chairs, wondering who dreams this stuff up.

With unbundling, it's easy to get modifiers wrong and accidentally bill for two separate procedures when there should have been just one. It's also easy to be untrained, or sloppy, or to commit outright fraud.

Anyway, I'm glad you caught the unbundling on your bill!

Re: Hidden Medical Debt Trips Up Homeowners

marty56 — Thu, 16 Dec 2010 17:17:29 GMT

@haulingthescoreup wrote:

Yes, they definitely do try, but if they have any sense at all, they won't try very long. Does your insurance company realize what the doctor's office tried to do? They're the ones with the ammo.

LOL they just told me not to pay it.

Re: Hidden Medical Debt Trips Up Homeowners

Anonymous — Fri, 24 Dec 2010 11:28:03 GMT

Look up Medical Debt relief act of 2009 also known as H.R. 3421. Not sure if it has passed yet or not, if it hasn't I think it will in 2011. Basically in the FCRA section 605(a) will be amended to add paragraph (7) which states: any information related to a fully paid or settled medical debt that had been characterized as a debt in collection for credit reporting purposes, which, from the date of payment or settlement, antedates the report by more than 30 calendar days.

Re: Hidden Medical Debt Trips Up Homeowners

MarineVietVet — Fri, 24 Dec 2010 14:26:13 GMT

@Anonymous wrote:
Look up Medical Debt relief act of 2009 also known as H.R. 3421. Not sure if it has passed yet or not, if it hasn't I think it will in 2011. Basically in the FCRA section 605(a) will be amended to add paragraph (7) which states: any information related to a fully paid or settled medical debt that had been characterized as a debt in collection for credit reporting purposes, which, from the date of payment or settlement, antedates the report by more than 30 calendar days.

Hello and welcome.

Here is a long thread about H.R. 3421 Medical Debt Relief Act of 2009.

From a BK years ago to:
EX - 9/09 pulled by lender 802, EQ - 10/10-813, TU - 10/10-774

"Some people spend an entire lifetime wondering if they've made a difference. The Marines don't have that problem".

Re: Hidden Medical Debt Trips Up Homeowners

valley_man0505 — Tue, 04 Jan 2011 20:28:24 GMT

It's really fun when the hospital tells you all the bills for a procedure are paid and then 2 bills pop up in collections less than a year later. My ex-wife had a major surgery right before we got divorced. Less than 2 months before applying for my first mortgage with my new fiance, 12 collections popped up on my report totalling $4,000 from my ex's surgery. I didn't realize that I would still be responsible for these bills since my divorce decree said she was responsible, but it turns out I was still legally liable for these bills regardless of what my decree said (of course, I could have had an open and shut lawsuit against my ex for this, but that would like trying for 5 gallons of blood from a 1 pound turnip). Anyway, I got lucky cuz the CA agree to PFD when I explained the situation. I had to take out a loan from my 401k as well as a personal loan to pay the $4,000, but I did it and it got rid of the CA on my reports and my FICOs creeped up to 620-625 (back when 620 was the target for mortgages).

After that, I checked with the hospital to make sure ALL the bills from her surgery and any other medical bills of hers that I could be responsible for were paid. The hospital billing said that EVERYTHING was now paid. Well, luckily I found a house and got my mortgage quickly because less than a year later, two new collections popped up from the same surgery. I found out one was from the anesthesiologist and the other one from the pathology lab. I asked the hospital how this could be right since they told me EVERYTHING was paid. The response was that even though the anesthesiologist and pathology lab were located within the hospital, their billing is done separately from the rest of the hospital. Well, the CA that had these 2 debts which totaled over $800 would NOT do a PFD--I had the money all ready to go, but never paid since they would not PFD. If they would have deleted, I would have paid as soon as I received a written agreement, but they wouldn't budge. So, now those debts are going to sit there until either HR 3421 passes or they debts reach CRTP (or, of course they could sue, but I think they would have done that by now).

So, yes, hidden medical bills can really destroy lives (I got lucky with the timing on my mortgage) and yes, HR 3421 would result in more medical bills getting paid.