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@babbles wrote:So what happened is Tricare authorized me referrals for a provider for therapy sessions for about 6 wks or so. TC paid the first 6 claims or so then somehow or another the provider's tax ID changed and TC, because of billing technicalities, denied the last 2 claims, ($96.55). In the process of denial, I had been constanly in touch with the provider and TC and even had the provider to call TC numerous times as well, but the claims were continually denied. So in the end, the provider sent the bill to collections because it wasn't paid. I kept after TC but nothing happened. I did send a detailed letter to TC as stated, along with the collecitons letter and detailing how my score with EXP has fallen by 67 points and it is critical that they assist me in getting supporting documentation to the CA that this was a TC technical issue.
Well, that stinks on Tricare's part, but IMO, it also stinks that your provider sent you to collections when you were working with them, especially for such a piddly amount.
Your position is shakier here, because you've already paid the CA. If you had paid the provider, you'd have a bit more leverage. Essentially, the privacy portion of HIPAA restricts the distribution of your medical info to entities that don't need it. If you had paid the provider instead of the CA, you could point out that the CA didn't need your info, and sharing it with them was a HIPAA violation, and so the collection needed to be withdrawn. (A gross oversimplification, but that's the basics.)
You are probably now reduced to GW (goodwill; aka begging for mercy) from the CA. They did get your money, this wasn't a misuse of credit on your part but a bureaucratic snafu instead, and although their agreements with the credit bureaus require them to report the collection, they aren't legally required to do so, regardless of what they say (or believe.) Lenders and collection agencies can and do remove negative info from credit reports every day, and none of them have gone to jail yet. It's a regulation, not a law.
I would still get Tricare to help put pressure on the collection agency, along with your provider. (We'll agree that it was your provider's billing service, rather than the actual provider. ) It would be a kindness, and the minimum that your provider's billing service to do, for them to tell the CA that you were sent to collections in error, that it shouldn't have happened, that it was the result of an insurance reporting problem, and that they (provider's billing service) would deeply appreciate it if the CA would cease reporting the collection, with a thinly-veiled threat that the billing service might look for another collection service to do business with if this one won't cooperate.
At this point, I think that you are pretty much at the mercy of these other people deciding to try to undo the damage that they have done to you. So although I know that I would find it awfully difficult, try to kill them with kindness in order to get them on your side. I don't know that you have any legal recourse. (I am very much not an attorney.)
And all this over $96.55. That's just pitiful.
Thank you for the detailed insight and prompt reply. I did send verification to the CA from TC that this was a billing error. I initiated a dispute through Experian 2 days ago. In your opinion, what do you think the CA's repsonse will be? The account is paid. Thank you.
Thank you for taking out the time to provide the detailed insight! As of now I have disputed this with Experian 3 days ago. Not sure what the outcome will be other than paid in full. I sent supporting documentation to the CA to show this was a billing error on TC's part. I have learned my lesson dearly throughout this. There were probably things I should have done, like pay the balance and then chase TC. They are processing the payment but still say I have to ensure the provider is in network even though they authorized the referral! This is aboslutely nuts! I will track my authorizations and claims meticulously at this point. Crappy customer service!
Just an update, as of this morning, the account has been deleted and my score unofficially, FAKO or not has increased significantly! I can't stand collection agencies! Prior to me paying the balance, they made all the assurances possible but once I paid they weren't interested in me. When I followed up with them 1 day later about the deletion of the account they referred me to file a dispute. I had already did that the day the I paid the balance. My lesson learned, once collections sends you notice, contact them immediately to find a resolution instead of waiting. I thought by paying them $20 of the $96 would hold them off till I squared things away with Tricare, no way!
@babbles wrote:Just an update, as of this morning, the account has been deleted and my score unofficially, FAKO or not has increased significantly! I can't stand collection agencies! Prior to me paying the balance, they made all the assurances possible but once I paid they weren't interested in me. When I followed up with them 1 day later about the deletion of the account they referred me to file a dispute. I had already did that the day the I paid the balance. My lesson learned, once collections sends you notice, contact them immediately to find a resolution instead of waiting. I thought by paying them $20 of the $96 would hold them off till I squared things away with Tricare, no way!
I'm glad everything worked out for you, even though you had to do some legwork that it wasn't your fault...
WOW! In a turn of remarkable events, just got a refund check from the collections agency, monies that to pay the balance to zero. All in all took about 2 1/2 weeks to get the file removed without the promise of DFP.