topic Re: Medical question in Rebuilding Your Credit

Medical question

Anonymous — Fri, 03 Oct 2008 14:08:02 GMT

My question is this. I have a collection on my report for a hospital bill. the only problem is the hospital knew at the time of service that it was a workmans comp claim. they never sent it to wormans comp. How do I handle this?

Re: Medical question

Anonymous — Fri, 03 Oct 2008 14:43:05 GMT

@Anonymous wrote:
My question is this. I have a collection on my report for a hospital bill. the only problem is the hospital knew at the time of service that it was a workmans comp claim. they never sent it to wormans comp. How do I handle this?

Get the Department of Labor involved (they oversee Workman's Comp). Complain, complain, complain. Or, if you like, tell the hospital that they'll be hearing from the DoL soon in regards to a complaint. That might get them to change their mind.

I'd also call your WC advocate (you HAD to have had one -- that was the "nurse" that facilitated your appointments and care -- basically oversaw the process and made sure you were treated fairly. The advocate is employed by the DoL, not your employer).

We've got experience with this. DH blew out his knee while working for the Navy. WC sucks. But the people did everything they could to make sure it was as painless as possible. Fortunately, our advocate was the BEST.

Problem with WC is that because the gov doesn't pay it's bills and uses miles of red tape to postpone paying the bills, healthcare providers would rather stab themselves in the eye rather than deal with WC claims. Within a 150 mile radius, only ONE healthcare provider (read, surgeon) accepts WC claims. Sad, huh?!

Holler back with details on what goes with the advocate ... I'm (and the rest of us, of course) here for you!!!

Re: Medical question

Anonymous — Fri, 03 Oct 2008 14:53:58 GMT

Forgot to ask: What state are you in?

Most states have actual statutes that REQUIRE the healthcare provider to submit the bills to the employer's insurance company. In FL, at least, it's against the law if they refuse to and bill the patient.

Oftentimes, the patient DOES have the option to pay the bills and be reimbursed -- but at least from what I understand from talking to DH's advocate and our HR office, it's frowned upon.

Re: Medical question

Anonymous — Fri, 03 Oct 2008 16:59:21 GMT

I live in the state of oregon. This happened 2 years ago when I fell ill with heat stroke while working on roof in 115 degree weather.

Re: Medical question

Anonymous — Fri, 03 Oct 2008 17:11:52 GMT

Did you file a Form 827 ("Worker's and Physician's Report for Workers' Compensation Claims.")?

I'm still researching -- it makes it oodles easier now that I know your state!

Re: Medical question

Anonymous — Fri, 03 Oct 2008 17:19:28 GMT

I don't really know what papers were filled out at the time my coworkers brought me in as I was almost unconscious. When in the hospital I signed so many papers I'm not sure. I'll probably have the call the OC to find out.

Re: Medical question

Anonymous — Fri, 03 Oct 2008 17:42:38 GMT

If they knew you were Worker's Comp, they're REQUIRED to submit the bills to the WCD (Worker's Comp Division).

Contact the OC and refer them to this regulation:

OREGON ADMINISTRATIVE RULES
CHAPTER 436, DIVISION 009
General Requirements for Medical Billings
436-009-0010 (1) Only treatment that falls within the scope and field of the practitioner's
license to practice will be paid under a worker's compensation claim.
(2) All medical providers shall submit bills to the insurer or managed care organization,
as provided by their contract for medical services, on current form UB92 or form HCFA 1500,
except for:
(a) dental billings which shall be submitted on ADA dental claim forms;
(b) pharmacy billings, which shall be submitted on the most current NCPDP form;
(c) EDI transmissions of medical bills pursuant to OAR 436-009-0030(3)(c).
Computer-generated reproductions of these forms may also be used. Billings shall include the
worker's full name, date of injury, the employer's name and, if available, the insurer's claim
number.

(I am assuming that since it was for heat stroke, it wasn't a dental claim.)

They're clearly wrong and breaking Oregon state law. If they give you any crap, inform them that you'll be complaining to the WCD dispute resolution team and requesting a full audit and investigation. Make sure to remind them that they'll need a lawyer.

You might also consider a suit. They damaged your credit.

Go get'em.

Re: Medical question

Anonymous — Fri, 03 Oct 2008 18:04:13 GMT

I just called the OC and they said I am not in their records as owing any money. They suggested to contact the CA and get more information from them.

Re: Medical question

Anonymous — Fri, 03 Oct 2008 18:11:59 GMT

@Anonymous wrote:
I just called the OC and they said I am not in their records as owing any money. They suggested to contact the CA and get more information from them.

Ah. Okay. Did they say that your bill is PAID, though?? 'Cause ultimately, that's what you want to have happened -- the bill to have been paid.

If they said it was PAID, start the HIPAA process.

OR tell them that THEY broke the law, THEY can talk to the CA and pull the *#@$% account back. That if they don't, you'll have a friendly chat with WCD Compliance. And the Ombudsman.

In fact, I'd let them know that you plan on calling the WCD, unless they do something about it by COB Monday, and filing a complaint and/or request for investigation. And perhaps seeing a WC lawyer later than day.

Escalate the sitch, though. Ask to speak to someone in WC Compliance. Or the Administrator. Anyone higher than the receptionist or billing department.

Re: Medical question

Anonymous — Fri, 03 Oct 2008 18:14:20 GMT

No offense, but I really don't think you quite comprehend the seriousness of breaking WC laws.

I'm not kidding one bit. They stand to lose a LOT. And if this is the way they treat people, they should.

Re: Medical question

Anonymous — Fri, 03 Oct 2008 18:15:50 GMT

When you do speak to someone in Compliance or the Administrator, reference OAR.436.009(2).

Then come back and tell us what THEY say. >

Re: Medical question

haulingthescoreup — Fri, 03 Oct 2008 20:40:45 GMT

I have moved jar1154's post off this thread to start a new one, as it is not addressing the OP's issue. New thread is titled "Getting Paid Medical Collections Off of Reports".

Re: Medical question

Anonymous — Sat, 04 Oct 2008 19:54:12 GMT

I spoke to OC's administrator today was on the phone with her for an hour and a half. Their computers have no record of me being in the hospital at all let alone owing any money. Their patient charts however have being there and the WC paperwork being filled out and signed. She said the reason it was put on me was because they never received payment from WC. I referenced OAR 436.009(2) and told her that I was bringing in the DOL to resolve this matter. She all of sudden got quiet and then said she will contact the CA and reflect that the matter is closed and paid. I said that I wanted it removed from my CRS as it is detrimental to my credit worthiness. She said legally they can't do that. I then told her that I was calling WC on this matter and seeking an attorney. She said she will be in touch with me monday or tuesday on what exactly can be done.

Re: Medical question

Anonymous — Sat, 04 Oct 2008 20:03:16 GMT

LMAO you did good peeler

To make sure that is is deleted I would follow the HIPAA process

Start with the Pre-HIPAA diaspute letter. It is sent to all CRAs reporting.

The correct colored paper & type in italics makes the CRAs do a manual reading of your dispute.

Hand write the enevolpe and mail CMRRR

Re: Medical question

Anonymous — Sat, 04 Oct 2008 21:01:34 GMT

@Anonymous wrote:
I spoke to OC's administrator today was on the phone with her for an hour and a half. Their computers have no record of me being in the hospital at all let alone owing any money. Their patient charts however have being there and the WC paperwork being filled out and signed. She said the reason it was put on me was because they never received payment from WC. I referenced OAR 436.009(2) and told her that I was bringing in the DOL to resolve this matter. She all of sudden got quiet and then said she will contact the CA and reflect that the matter is closed and paid. I said that I wanted it removed from my CRS as it is detrimental to my credit worthiness. She said legally they can't do that. I then told her that I was calling WC on this matter and seeking an attorney. She said she will be in touch with me monday or tuesday on what exactly can be done.

Whooo-hoooo!!!! I KNEW it!!!

By NLT Tuesday, it'll be taken care of!! If not sooner!

I can betcha that the whole office is in a frickin' panic!! They broke several state and Federal laws and SHOULD be peeing themselves stupid!!

Don't back down, though. While I'm sure it was an innocent misunderstanding, it still *blanked* you over. You NEED to be made "whole." Don't accept anything else!!

You let us know what happens, okay?!

Re: Medical question

Anonymous — Sat, 04 Oct 2008 21:10:34 GMT

DW and I were talking and she thinks that I should contact an atty anyway for a suit because they really messed up my credit.

Re: Medical question

Anonymous — Sat, 04 Oct 2008 21:19:21 GMT

@Anonymous wrote:
DW and I were talking and she thinks that I should contact an atty anyway for a suit because they really messed up my credit.

I'd seriously think about it, too. And free tip (not meant sarcastically or smart-mouthy -- some people honestly don't know that!), most WCD lawyers work on contingency. So you'd not be out of any out-of-pocket expenses.

I really think it was a misunderstanding (or just plain stupidity -- the gov doesn't make WCD easy to work with, you know). But seeing as how you tried to clear this up previously and are only getting the attention you DESERVE now, that you've brought in the DoL/WCD, I think it's just being negligent.

Go get'em!!

Re: Medical question

haulingthescoreup — Sun, 05 Oct 2008 02:33:29 GMT

Sweeeet!

Every now and again, the good guy wins.

Re: Medical question

Anonymous — Wed, 08 Oct 2008 00:07:54 GMT

Update*****

The CA called me today on this and assured me that this is going to be deleted from my account, but I have to wait until w/c accepts the paperwork. The lady went as far as to tell me she would help with this matter personally. Are they that afraid of w/c claims and lawyers???

Re: Medical question

Anonymous — Wed, 08 Oct 2008 00:39:46 GMT

@Anonymous wrote:
Update*****
The CA called me today on this and assured me that this is going to be deleted from my account, but I have to wait until w/c accepts the paperwork. The lady went as far as to tell me she would help with this matter personally. Are they that afraid of w/c claims and lawyers???

Oh, &*$#@% YES, they are!!

Even if the sanctions they face from p*ssing off the Federal and state government don't faze them, the thought of dealing with vicious and vitriolic WCD (AKA personal injury lawyers) lawyers will scare them to their toes -- not to mention the bad publicity they'd receive once the case went to trial and every Greta Van Sustern and Wolfe Blitzer wannabes showed up!!

WCD is serious. VERY serious. They SHOULD be peeing themselves. Really.

Be tough. Stand your ground. You got *blanked* now it's up to THEM to fix it.