My turn! Starting on DH's medical collection

[haulingthescoreup]

OK, everyone, here I am, a complete collections noob, needing guidance.

DH has a medical collection for $94 on EQ and TU (not EX.) I pulled his full EQ to get the OC info, and it's an ER physician bill from June 2002 from a hospital in Illinois. DD#1 was at a summer goalkeeper camp when she had an asthma exacerbation, and off she went to the local ER. DOFD is 07/2002; turned over to collections 04/2003; last reported 11/2007. No payment has ever been made. (Duh, since we never knew the bill had not been paid.)

I called the OC, which had to go into the hospital's legacy computer system to find the original info. The physician's billing employee I spoke to (very nice) said that we had paid the $50 deductible, and our insurance company at the time (John Deere) had paid the balance of the facility charge, but that they had not paid the physician's charge. It is even possible that we have paid this, because we sort of remember sending two separate checks, but DH threw our old bank statements and check registers in the trash last year. (Pause while I try to calm down again from that.)

John Deere Healthcare has since been sold to United Healthcare, and when I called them, their systems were down for updating, and I never could get back with a human. (On top of which, they are no longer our insurance carrier.)

The OC said that the debt had been either sold or turned over to the CA (Merchant's Credit Guide.) I asked her if they could pull back the debt from the CA if I paid the OC directly, and she didn't know. She had never heard of PFD. The CA has never once contacted us in an attempt to settle the debt, and the OC sounded pretty upset to hear that.

It is past SOL in Illinois where the service took place (5 years), but it is not past SOL in Tennessee, where we live (6 years.)

Here is where I want things to end up: I want the OC to have their $94, and I want the collection off DH's reports, never to return.

Where do I start gnawing on this beast? my guesses, please tell me where I'm wrong:

(1) find out from insurance company why they didn't pay, and get them to pay if possible
(2) if insurance won't pay, offer a PFD to the OC (for full amount, btw, I'm not interested in ducking this)
(3) if OC can't or won't pull the debt back from the CA, then what? Here's where I get shaky.

I think that I've read that if the OC accepts the payment (with a promise on their part to never report anything derogatory, btw), I can then dispute the collections as "not mine," since there is no longer a debt. This sounds to good to be true. Is this correct? And more importantly, is this cast-iron? I really want this sucker off DH's reports. It obviously should never have been there in the first place.

Any help and guidance gratefully accepted!

[Anonymous]

Hauling-

Is Merchant's showing on your CRAs? OC too? I had a med collection from Merchant's last year. Kinda same deal, a copay from an E-room visit when I was cruising in Florida. The OC was not showing on my CRs, only Merchant's.

I called the OC, they said to deal with the CA. Instead, I just sent a check to the OC. Once it cleared I disputed the CA account with the CRAs & it went poof. 

Maybe not by the book, but it worked for me.

GL

[haulingthescoreup]

---

@Anonymous wrote:

Hauling-

Is Merchant's showing on your CRAs? OC too? I had a med collection from Merchant's last year. Kinda same deal, a copay from an E-room visit when I was cruising in Florida. The OC was not showing on my CRs, only Merchant's.

I called the OC, they said to deal with the CA. Instead, I just sent a check to the OC. Once it cleared I disputed the CA account with the CRAs & it went poof.

Maybe not by the book, but it worked for me.

GL

---

Wow, Anderson, carbon copy!

Yes, only the Merchants (CA) is showing on his report, not the OC. That's why I didn't know if paying the OC would be the place to start.

How did you dispute the collection once the OC was paid? "Not mine", or what? I should know this by now, but my brain is just sort of lying here, gasping.

edit: cna't speel. And again after reading more closely!

Message Edited by haulingthescoreup on 02-09-2008 06:58 AM

[Anonymous]

After I paid the OC and the check cleared (it was less than $50) I disputed with the CRAs. Not sure of exact dispute wording but I think I just said something like "Medical Bill, PAID by INSURANCE, Not my debt."

Merchant's seemed to fold easily in my repair efforts. Never even DV'd them. YMMV.

This was before I began reading Whychats methods, you may want to read his stratagies first, re- HIPPA.

[braznyc]

Do you need a new number for United Healthcare? They keep everything on microfiche. My dad is a doctor and I use to do his medical billing and still help out. Be very careful with this, before you pay, and I say this because EVERY insurance company sends out an explanation of benefits to the doctor and the patient, IF the hospital was in network then that whole billed you for the physicians fee needs to be checked, because the EOB may say that he can't bill you for those fees. They make payments based on usual and customary and if you have someone who is clueless on how to read an EOB then you could end-up paying something you're not suppose to, especially if the doctor is PAR which means participates and has a contract with the insurance to accept a certain payments and policies etc. I'm only mentioning in case you wanted to still seek info from United Healthcare. The insurance specifies what they can't and can bill you for IF they're in network, if they're out then they can basically bill you their entire fee minus what they got paid from the insurance. There are laws on when they can delete records, so they may still have it, especially if it was a buyout, they're very careful about that. United Healthcare actually is one of the better insurances to deal with, and I can get you a number to speak to a real person, it's just a lot of prompts. But there is a general number that providers and non-providers use, once you get a person, explain the sitation and they'll get you to a real person that can help you. I can get the number for you Monday as I don't remember past the first 3 digits right now lol.

Anyways I think the idea of paying the OC might work, because hospitals tend to just deposit checks and if you're still in their system they won't refuse the payment. If you DV the current owner then they'd have to send you whatever the hospital sent them, which should include a copy of the EOB.

[islandchild82]

Braznyc has it exactly right. EOBs need to be checked for all medical/dental claims because hospitals and doctor's offices often process them incorrectly. Definitely check whether the hospital was participating/nonparticipating.

Of course, that is assuming you didn't have an HMO at the time. HMO's in California, to my knowledge, do not send EOBs to patients outside of Medicare Advantage plans (do they anywhere?). So, depending on your insurance coverage, you may have never received an EOB if the treating hospital were in your HMO contract.

[Anonymous]

Hauling, I was in similar situation with my daughter. Took her to the emergency room (twice), didn't pay the hospital, and 2 collection wound up on my CR's.

I don't know if it will help, but here's how I got my 2 deleted from the cr's. It's a post I made from 10/23/07:

Bren, the exact same thing happened to me. Took daughter to ER. I was responisble party. Got a $169 charge that went to collections.

Called CA and told them that I'd PFD. They said they can only mark CR as paid, $0 bal. I told them no deal. I have no incentive to pay in full, and just have it marked as paid. I want it gone! They told me only the hospital can instruct the CA to delete the baddie, as the hospital still owns the account.

Called hospital and told them same thing. PFD. They said they'd instruct CA to mark it as paid. I said that I will bring them a cashier's check tomorrow, IF and ONLY IF they:
1.) Instruct CA to immediately to delete the collection from CA
2.) IF they would provide me an original duplicate, on hospital letterhead, the letter instructing CA to delete. After the csr at the hospital checked with the head of the dept., they readily agreed.

Went to hospital, they gave me the letter(first)then I gave them the cashier's check. Got verifying letter from CA that the collection had been deleted. (letter available on request.

I know I should have done this via mail, but I was young, dumb and didn't know no better. lol

2 weeks later, I receive a letter from the CA telling me, they've put through paperwork to have the collection deleted. (letter available upon request. And a week later, it had been deleted from the cr.

Sorry for the length. I don't know how to tell the short version

[braznyc]

Ditto to Islandchild's comments. The biggest reason I say double check how it was paid, and what they said you're responsible for (if you can) is I've been there done that with billers who were clueless as to how to read an EOB, and I paid and it took me forever to get my money back. Now of course the amount you owe isn't much, but if it can be verified I say confirm it's actually something you should be paying.

[haulingthescoreup]

Thanks to everyone--great info!

As best as I can tell, the CA now owns the debt, as the OC does not report it on DH's report --just the CA. But I am going to confirm with the billing supe as I get further into all this mess.

DD was out of network at the time, as we are in Tennessee, and she was in Illinois. So I knew that we'd pay more, but I find it bizarre that John Deere was willing to pay for the hospital ED charge after my $50 copay, but zip on the provider bill. So hurray for microfiche, and I hope that the John Deere stuff is accessible as well. Maybe it will show whether the bill was submitted at all, and if it was rejected for coding errors, etc. (This is my field, Mr. Insurance Company, don't mess with me about coding! )

I love EOB's and statements. The EOB tells you don't pay anything yet. The statements say pay it all. You call billing and they say that it's still going back and forth between them and the insurance, so hold off for the time being. And there I sit, checkbook in hand, waiting.

Since this was 5 1/2 years ago, our memories are hazy about whether we sent in a second check, which would have been for the physician bill. I know that we paid the co-pay, as that shows on their records, and was applied to the facility bill. I also remember going by the hospital when I went to pick DD up at the end of her week of 8 hours a day in goal (she slept for 3 days afterwards, lol.) I tried to pay the co-pay then, and they said no. grrrr


edit to add: since this is out of SOL in Illinois (5 years), but still within SOL in Tennessee (6 years), will this be an issue if things get ugly with the CA? I thought I read that they could elect to go with the SOL of the state where the debt was incurred, OR with the state of residence, but I can't seem to find anything about that now. double grrr

Message Edited by haulingthescoreup on 02-09-2008 12:17 PM

[Dawn]

haulingthescoreup wrote:...

It is even possible that we have paid this, because we sort of remember sending two separate checks, but DH threw our old bank statements and check registers in the trash last year. (Pause while I try to calm down again from that.)

See .. just more justification for me to keep my records all the way back to 1970!    OK ... I know that is a little much for medical billings, but gee ... we are always being surprised by things that pop up so far down the road that we would have never thought in a million years that we still needed that information!