New Collection Account

[Anonymous]

I need some advice from you all regarding my Fiance's situation.

She has chronic migraines and early this year her neurologist recommended botox injections in order to help prevent her migraines. She told her Dr. That she would be fine with that so long as her insurance would cover the majority of it. The Dr's office sent off for a pre-authorization to her insurance and insurance said they would cover it as long as the Dr. sent her records and a letter of medical necessity. Dr. said everything was good to go with insurance so she went ahead with the injection's.

Fast forward a few months and she recieves a bill from the hospital for around $5000 for the cost of the injection's. She called the Dr's office immediatley and insurance and filed an appeal referencing the pre-authorization number and all. Insurance says they are only willing to cover the cost of the procedure and not the cost of the botox itself which is where the $5000 bill came from ( personally I think 5 grand for botox is an outrageously inflated number). Insurance recommended she send a copy of the bill to her prescription insurance in hopes that they would cover the botox. So we have been in the process of doing that and have been waiting to hear back from them. The dr's office failed miserably in my opinion and didn't give an honest effort to try and resolve the issue.

And today she recieves a phone call from H&R accounts which is a collection agency, who left her a voicemail while she was at work.

At this point I am not exactly sure what to do, I blame the Dr.'s office for the whole ordeal as they recieved a preauthorization from insurance, which insurances states they only preauthorized the procedure not the botox itself....

I am trying to contact a lawyer, but I was wondering what we can do, we plan on pulling her credit in the next few days to see if the collection account is listed yet, but we want to desperatley get it off her credit. We both have perfect credit and we are afraid the collection on her reports will dramatically affect her score.

I have read before you can ask the collection agency to pay for delete which will remove it from the bureaus, but is there negotiation room in doing so, so we can possibly settle on a lower amount and still pay for delete?

We need some guidance, any help is appreciated!

[CreditInspired]

If it hasn't reported yet, please do everything in your power to prevent that from happening! I think since the pre-auth states the injections itself is not covered, your GF is responsible for the exorbitant cost. I think you may be able to set up a payment plan with the collection company to thwart being reported to the credit bureaus. So sorry that this is happening. GL to the both of you.

[Anonymous]

this whole ordeal has been very frustrating, we have the money to pay the bill in full.... however we were holding out because her prescription insurance is possibly covering it. My fiance called the Dr's office to let them know that she was working with her insurance and asked for an extention... nothing happened for a month while we were still waiting to hear back from insurance (called today and no answer yet)... then she got the called today from a collection agency, so we called the Dr's office and they said they sent out a final notice bill but we never recieved it... we Closed on our house a few months and I am afraid that maybe with the change of address we never recieved the bill because of that. I just want to ensure that this doesn't affect her credit....

[Anonymous]

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@Anonymous wrote:

this whole ordeal has been very frustrating, we have the money to pay the bill in full.... however we were holding out because her prescription insurance is possibly covering it. My fiance called the Dr's office to let them know that she was working with her insurance and asked for an extention... nothing happened for a month while we were still waiting to hear back from insurance (called today and no answer yet)... then she got the called today from a collection agency, so we called the Dr's office and they said they sent out a final notice bill but we never recieved it... we Closed on our house a few months and I am afraid that maybe with the change of address we never recieved the bill because of that. I just want to ensure that this doesn't affect her credit....

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Couldn't you still pay it and then get a reimbursement check from the prescription insurance company as long as they were going to pay it?

[RobertEG]

It is best, if possible, to get the debt paid via insurance rather than paying yourself.

Under the new "National Consumer Assistance Plan" recently implemented jointly by the big-3 CRAs, any medical collection shown to have been paid via insurance will be removed by the CRA without any imput or involvement of the debt collector.

[Anonymous]

update on our situation.

We went to the Dr's office and they informed us that the collection agency they use just services their outstanding accounts and that they do not report to the bureau. We settled the ~$5200 bill with the office for ~$1600 after showing them that previous EOB's when my fiance was insured under her mom only paid that amount on the same treatments. We recieved a receipt showing the account number and balance relfecting $0 and we were told the collection agency will not be contacting us any further and that everything is settled. Crossing our finger's that this is the case and that nothing else comes up, will be pulling fiance's credit next month to ensure that no collection accounts have shown up.