Medical Chargeoff Being Charged Interest Randomly....

[IOBA]

My SO had an emergency medical problem & surgery in Jan 2017.  He had two insurance companies that basically gave him 100% coverage.  We only pay for meds from the pharmacy.

The imagining center - connected directly to the hospital but in a stand alone building - only billed the primary insurance company, although both insurance providers info was provided.

Within two months, SO was back in the same imagining center.  I verbally gave them the information & asked them to bill BOTH insurance companies, gave them a written letter asking the same, & followed up with a phone call when I recieved the bill.  I was verbally assured that this would be taken care of immediately.  (The primary insurance company said it was patient responsiblity to pay $370 or something like that.)  That seemed to be the end of that.  Never received another bill from the center.  In fact, received refund checks from the hospital network for being overcharged!  (We had paid some of the bills out of pocket to avoid collections while they sorted out the insurance.)  At the time, we did not receive any EOB's from the secondary insurance company for anything.

Fast forward to one year, SO goes back for another MRI.  No problems billing both insurances.  Balance due - zero.  

In April 2022, a collection pops on SO's CR.  Balance $471. The account is coded as "CHARGED OFF."

Four weeks later, the charged off account updates to a new balance of $473.

Two weeks later, the charged off account updates to a new balance of $475.

Collection agency says the date of default is 05/2018 with the most recent activity being 06/2022 (where they added more interest.)

1.  If the account is coded/has the status as a "CHARGED OFF" - can the CA continue to charge interest, irratically, & update the account?

2. Isn't there a rule about being consistent in charging interest & updating the account?  Why charge interest at 4 weeks, then suddenly at 2 weeks? Who knows when it will be next?

3. The SOL is past on this debt for the state (VA) that the debt was incurred.  Ironic that it showed up now, when it's past the SOL.  There was no activity on the CR other than paying bills.  

4.  There has been no written or verbal communication from the CA (Proggressive Management Systems).

What are the options?  Paying them is NOT an option - the bill would have been paid in full by the insurance company if the person had billed the insurance company.  In the last 7 years, we have not had to pay any medical bills for him - he has full medical coverage.

Thanks.

[FireMedic1]

Go to the hospital with all you mentioned and sit down with the business associate and go over all of it. If not pleased. Ask for the Dept Manager. Hospitals do want to work with you and want you back as a Patient. In person works so much better than e-mails and calls.

[Spotsy]

@FireMedic1 is totally correct...sitting down face to face with them is the BEST next step.  

in the event you are being 'hustled' by the hospital or any other medical debt issue, keep in mind the following pieces of info:

1) the must provide all artifacts of interactions with the insurance agencies.

2) verify they even submitted the claim to insurance for processing, if the didn't , there are time limits to what they can submit for payment, else it is a write off on their end, NOT a charge off to you. 
3) verify they/you did not agree to 'balance billing'..most insurance companies don't allow that when dealing with hospitals/major medical stuff (need to double check this though)

4) spend time tracking the charges from inception to payment, etc...make sure nothing  just magically 'appears' out of now where, or get re-classified.  There are some medical billers that move money around to try and get paid for non-covered items or other mistakes they make.

If it's is from a 3rd party that the hospital contracts with then you may need to deal with them directly to clear it up. In all of my dealing with medical claims...I ended up walking away with a check in hand for various reasons.  I thought medial debt was no longer reported to CRAs? The hospital may have been also paid for the service and a credit is sitting on one of your accounts that simply needs to get moved to another...seen that happen too.

[IOBA]

Thank you.

I reached out to the insurance company today.  The insurance company verified that no claim had been submitted for payment ever for the date of service (01/2017).  The same medical provider has submitted subsequent claims & been paid in full.

The insurance company suggested I use an advocate to have this resolved.  The insurance company stated they would accept a claim this late (even though it's been 5.5 years since date of service.)

Going to call advocate now.

[Cowboys4Life]

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@Spotsy wrote:

@FireMedic1 is totally correct...sitting down face to face with them is the BEST next step.  

in the event you are being 'hustled' by the hospital or any other medical debt issue, keep in mind the following pieces of info:

1) the must provide all artifacts of interactions with the insurance agencies.  I don't even know what an "artifact" of interactions with insurance agencies is.  This makes no sense and I have spent over 40 years in healthcare.  It also isn't true.  NOTHING requires a provider to file a claim on an insureds behalf.  Most do as a convenience but the insured is ultimately responsible if they want to use their coverage.  

2) verify they even submitted the claim to insurance for processing, if the didn't , there are time limits to what they can submit for payment, else it is a write off on their end, NOT a charge off to you. Patently FALSE.  As I said above NO provider is required to prove they filed the claim and write it off if they didn't do so.   You really need to read the financial guarantee you sign so you understand what you are agreeing to as well as the requirements of coverage by your carrier.  YES, there is a time limit to file a claim which is why anyone using their coverage should stay on top of all bills for care to ensure that if the provider doesn't file the claim they do to protect their coverage that they pay for and get care covered.
3) verify they/you did not agree to 'balance billing'..most insurance companies don't allow that when dealing with hospitals/major medical stuff (need to double check this though)  FALSE.  If an insured goes out of network to a provider who is not under they can balance bill.  A contracted provider is legally prevented from balance billing.  Both the financial guarantee that is signed prior to care being rendered and your insurance policy spell this out.  Use an out of network provider and you can be subject to balance billing.

4) spend time tracking the charges from inception to payment, etc...make sure nothing  just magically 'appears' out of now where, or get re-classified.  There are some medical billers that move money around to try and get paid for non-covered items or other mistakes they make.  None of this nonsense is true either.  Most providers have a billing department that does regular accounting but there is no special requirement they designate specific time to the imaginary processes you speak of.

If it's is from a 3rd party that the hospital contracts with then you may need to deal with them directly to clear it up. In all of my dealing with medical claims...I ended up walking away with a check in hand for various reasons.  I thought medial debt was no longer reported to CRAs? The hospital may have been also paid for the service and a credit is sitting on one of your accounts that simply needs to get moved to another...seen that happen too.

I don't know where most of this nonsense came from but it isn't accurate.

To the OP:  open a claim with your secondary carrier immediately and see if you can get it covered.  Go to the manager of the billing department for the provider for this bill.  If they are in another building odds are high they simply rent the space from the hospital and the billing is their own and not the hospital's.  If that is the case the hospital isn't able to do anything about this.

You are fortunate to have two policies.  Most providers will file with both companies because getting all their money is preferred.  However, some are not set up for it.  ALWAYS make sure that a claim is opened after you get care.  If it isn't opened by the provider and a phone call doesn't get the process started, YOU open a claim.  The provider is legally obligated to respond to the insurance carrer for any information that is requested to process the claim.  It would be nice to be able to say "just bill both my insurances" and forget about it but sadly that isn't the case and the charged off bill is why.

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I don't know where most of this nonsense came from but it isn't accurate.

To the OP:  open a claim with your secondary carrier immediately and see if you can get it covered.  Go to the manager of the billing department for the provider for this bill.  If they are in another building odds are high they simply rent the space from the hospital and the billing is their own and not the hospital's.  If that is the case the hospital isn't able to do anything about this.

You are fortunate to have two policies.  Most providers will file with both companies because getting all their money is preferred.  However, some are not set up for it.  ALWAYS make sure that a claim is opened after you get care.  If it isn't opened by the provider and a phone call doesn't get the process started, YOU open a claim.  The provider is legally obligated to respond to the insurance carrer for any information that is requested to process the claim.  It would be nice to be able to say "just bill both my insurances" and forget about it but sadly that isn't the case and the charged off bill is why.

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