cancel
Showing results for 
Search instead for 
Did you mean: 

Please help with medical collection issues!

tag
tonsers
Frequent Contributor

Please help with medical collection issues!

My parents are thinking about refinancing so I pulled their CRs for them. To their surprise, there is a medical collection on my dad's CR which is his only baddie in an otherwise stellar history.

My mom told me that when she started getting calls from the CA (in 2005), she told them that Medicare was supposed to pick up the first part of the bill, and that their supplemental Blue Shield should cover the rest. She called the surgery center and they told her they would look into it. Just about that time - the calls from the collection agency stopped, so she assumed it was all taken care of. (Never wise to ASSUME anything about your credit, right? Smiley Tongue )

I called the surgery center yesterday to get info as I didn't want to stir anything up with the collection agency. Here is what I found:

There were two bills that were turned over to a collection agency. The second was from September 03 ($137) and Medicare should have picked it up. The hospital did not turn the bill over to Medicare.

The first bill is a little trickier. The service was in April 2003, just 10 days before Medicare kicked in for my dad. So when the bill came in May, my parents thought it was taken care of, but in fact it was not. Amount of invoice was $116. Looks like this was a mistake/oversight on my parent's fault - or course they would have paid if they understood.

So here are my questions:

What should they do about this now? Deal with the OC or the CA? Will calling the CA open a can of worms or even re-date the file? Do you think that a PFD on only the legitimate invoice is possible?

Surgery center told me that it is too late for them to turn the second invoice over to Medicare - but my parents did tell them years ago that it was not their responsibility. Can anything (short of my folks paying) be done about this one?

I appreciate any advice that you can offer! Smiley Happy
tonsers
Message 1 of 13
12 REPLIES 12
Anonymous
Not applicable

Re: Please help with medical collection issues!

Google whychat hipaa
 
this letter is from whychat
 

This letter is intended for the original creditor health care provider and is designed to obtain a deletion from credit reports, and stop collection agency activity.

It is NOT applicable if the account is valid and you are unable to pay it.

It will ONLY work if the claim is either INACCURATE, or you remit the valid correct amount due with the letter.

Please make sure that your payment is in the form of a bank cashiers check or bank money order,(do not use a postal money order) that you make a photo copy of the front and back of the remittance, that your name and address are CLEARLY printed on the remittance, that it is made to the order of THE ORIGINAL HEALTH CARE PROVIDER, and that you print or type clearly in the endorsement section "For Deposit Only to the Account of (name of H.C. provider)(This of course allows your IRS deduction as a medical expense)

Send ALL correspondence to the LEGAL DEPT. of the HC provider,CMRR. Do NOT "fax" or "e-mail" anything.

HIPAA & FCRA The Legal Basis

FORM LETTER TO ORIGINAL HEALTH CARE PROVIDER

(Your Name)

(address)

(City,State, zip)

s.s.# (social security #)

Legal Dept.

( health care provider creditor)

(address)

(date)

Dear Sir/Madam;

This letter is in reference to (account #) for services provided to (name of patient) on (date of service).

In regard to the bill on this account in the amount of ($___):

Insert correct insert hereSmiley Sad see inserts) (a) (b) or (c)

Please be advised that under Federal Statutes. the Fair Credit Reporting Act, (15 U.S.C. § 1681 et seq)and (name of your State)'s Consumer Credit Statutes, you may be held liable for the actions of (collection agency name).

(a) Duty of furnishers of information to provide accurate information.

(1) Prohibition.

(A) Reporting information with actual knowledge of errors.

A person shall not furnish any information relating to a consumer to any consumer reporting agency if the person knows or consciously avoids knowing that the information is inaccurate.

In addition, the HIPAA and (name of your State)'s Medical Privacy Statutes are in effect in this situation even though the health care services you provided may have been prior to enactment .

The Privacy Rules prohibits a covered entity from using or disclosing an individual's protected health information ("PHI") unless specifically authorized by the individual or otherwise allowed under the Privacy Rules.

In general, PHI encompasses substantially all "individually identifiable health information" that is transmitted or maintained in any medium. "Individually identifiable health information" includes health information that is created or received by a health care provider, health plan, employer, or health care clearinghouse, and that relates to an individual's physical or mental health or condition, including information related to an individual's care or the PAYMENT for such care.

Your furnishing of my account information to (collection agency name), is not in compliance with HIPAA,or (name of your State}'s Privacy Act, and any subsequent reporting of this account on my credit reports to (credit reporting bureaus) is a clear violation of Public Law 104-191 ("HIPAA") since there can be no permissible business purpose in divulging protected health information to anyone on an account once there is no longer any payment due.

You are required under the FCRA and FACTA to accurately report the status of any account to the credit bureaus, and you are prohibited under the HIPAA and State privacy regulations from doing so on a PAID account, as there is no longer any permitted business purpose.

Therefore I am requesting you promptly rescind all such account information furnished to (collection agency) and require them to purge their records of all reference to this account, and that you insure that any and all reporting of this account is immediately deleted from my credit reports.

This simple procedure to request the deletion of ALL reference to this account from the records of ( collection agency name) and to require them to have this account information deleted in its entirety from my credit reports will resolve this problem completely.

Please respond, in writing within 10 days that you are processing this request.

I am reserving the right, to take appropriate legal and civil action including reporting to any applicable regulatory authorities any lack of cooperation or compliance with this request.

I hereby waive my rights under HIPAA and any State Privacy Act for the single purpose of your transmission of this request and accompanying documentation in any required report you must make to your E &O insurance carrier.

Sincerely,

signature

(Your Name)

INSERTS

............................................................................ .............................................

(insert a)

Enclosed please find my remittance of ($___) for payment in full of this account.

(insert this if the payment is less than billed)This payment in full is for services as per the attached fee schedule from XXXX XXXX)

Health Care Billing Charts

Please note, my remittance is payable ONLY to (hc provider) and may not be signed over or transferred to any third party collection agency, as this would constitute an additional violation of HIPAA and State Privacy Act rules .

Copies of this correspondence and a copy of the remittance check may be used for any further actions with State or Federal agencies

.......................................................................... ..............................................

(insert b)

This account is in error.

It has either been paid, is a billing error,or was not transmitted in a timely manner to my insurance company.

It is not a valid bill and has been properly disputed, therefore I request complete deletion from all your records and archives.

.......................................................................... ...............................................

(insert c)

This is not my account,

It has been billed to me in error. and has been properly disputed, therefore I request complete deletion from all your records and archives.

Message 2 of 13
tonsers
Frequent Contributor

Re: Please help with medical collection issues!

Thanks for the info, Lady Scarlet! Smiley Happy Does it matter that this collection account is for two bills, though? One is valid and one should have been paid by Medicare. Do I need to deal with these two issues separately?
Message 3 of 13
Anonymous
Not applicable

Re: Please help with medical collection issues!

I would deal with them separately.
Message 4 of 13
tonsers
Frequent Contributor

Re: Please help with medical collection issues!

Sorry if I'm beating a dead horse - I just want to be super careful - if I screw up my parent's credit they will never forgive me! Smiley Tongue

So I send the letter that you posted to the hospital regarding the second invoice.

For the first invoice - should I offer a PFD to the hospital or the collection agency?

Thank you sooo much, I really appreciate the info! Smiley Happy
Message 5 of 13
Anonymous
Not applicable

Re: Please help with medical collection issues!

PFD to the hospital/doctor/OC.  do this first!!! then tackle the 'you messed up so eat the costs, sucker" one.
 
Message 6 of 13
Anonymous
Not applicable

Re: Please help with medical collection issues!

I'll tell you my recent experience.   I called the hospital directly and got them to pull the collection back from the CA (which was deleted from all of my CR so far except EQ).  They did this after I paid the amounts due.  I did not get a letter saying they would do it(which is a no no almost all the time) but, what I did was get the names of the supervisor and VP and actually spoke to a supervisor to confirm they would delete.  I then paid them over the phone and within 24 hours 5 med collections were deleted from my Ex report still waiting for Eq to update..slackers. 
 
I'm only mentioning this in case you decide to take this route instead...good luck..
Message 7 of 13
tonsers
Frequent Contributor

Re: Please help with medical collection issues!


@Anonymous wrote:
I'll tell you my recent experience. I called the hospital directly and got them to pull the collection back from the CA (which was deleted from all of my CR so far except EQ). They did this after I paid the amounts due. I did not get a letter saying they would do it(which is a no no almost all the time) but, what I did was get the names of the supervisor and VP and actually spoke to a supervisor to confirm they would delete. I then paid them over the phone and within 24 hours 5 med collections were deleted from my Ex report still waiting for Eq to update..slackers.
I'm only mentioning this in case you decide to take this route instead...good luck..





Thanks Lady Scarlet and GETNUMBERSUP! I really appreciate your input!

I just called the hospital and discussed this with them, but I'm not sure that the girl I was speaking with understood myFICO language! Smiley Wink I asked her if I could pay for delete - to make sure that these were removed from the CRA reports. She said that they would be marked paid. How would this be different than a paid collection?

She also mentioned that there may be fees from the collection agency that I may have to deal with separately. Does this sound right??? Obviously I'm not going to do anything until I'm 100% sure that I'll get the desired end result.

Also, LadyScarlet, re PFD of one invoice, then taking on the "suckers" who made the mistake on the other (BTW - that made me laugh so hard - EXACTLY what I felt like saying to them on the phone!! Smiley Happy ).... is it possible for them to delete since these two invoices are part of the same collection account? It won't re-age the other, will it?

Thanks again soooooo much!
Message 8 of 13
tonsers
Frequent Contributor

Re: Please help with medical collection issues!

One more thing that the hospital told me... They said that they could try to submit the one invoice to Medicare but since it is so old, they may not pay it. She said that I could pay now and if Medicare paid it - she would the hospital would reimburse me. She said that my dad's Medicare number was not in the file so it would be patient responsibility. Is this they way it works????
Message 9 of 13
Anonymous
Not applicable

Re: Please help with medical collection issues!

yeah..it's technically the patients responsibility to file claims but, the hospital does it as a courtesy...What happens is if the hospital does have insurance information on file and for some reason they do not file they can default assign the insurance card holder as guarantor...They can refile the claim and it will be denied initially due to timely filing.  However, you may appeal the insurance company and ask for reconsideration of the claim(they may or may not pay). I would call back to the hospital and request a supervisor.  Just ask them that if you pay the collections will they pull them back from the CA and request the CA delete the items from your report.  You do not want them marked as paid....You want them deleted.
Message 10 of 13
Advertiser Disclosure: The offers that appear on this site are from third party advertisers from whom FICO receives compensation.