Roadie

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About Roadie

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  1. To Hotwheels: The dates for the two surgeries are two weeks apart, not a month apart. .....in demanding validation, its true they provided an itemized listing of services, but only for the 3-30-2011 surgical date (this references to the $970 contested amount).... They omitted providing the itemized listing of services for the 3-15-2011 surgical date (this references to the $540 account, and this very account is paid for, yet its still lumped together and in the hands of this CA... This is the fdcpa violation I was wondering about since the $540 account has no business being in the hands of a CA. To RaceCar: Thank you for that link, Ive previously been to WhyChat's site, but dont think I can dive in until I get a fix for this account of mine, with service date 3-15-2011 with a billing amount of "$540". This is a totally paid up account, even though the hospital administrators split my payments among the two accounts making it look like both remain unpaid for. To BTO: Yep, this was thru In-Network, private insurance, alright. So does this mean Balance billing as an illegal activity has no standing? If Im wrong, then the $970 is indeed owed to the hospital that provided me services on the 3-31-2011 service date account. I thought my EOB showed I maxed my medical cap for the 2011 fiscal year, and any further expenditures is covered at "100%" (up to their contractual rate, I understand that much ) which is why I objected to what I originally considred "duplicate expenditures"... maybe I expressed my objections the wrong way. Still, me thinks, the $540 account billing has no business being in the CA's hands, nor does the total amount as reported to the credit bureau files ($1510.00) is correct, its a mischaracterization of the correct amount, at any rate. I was hoping for a fdcpa potential over a hippa claim in the first place. Me wrong? Advise. Roadie
  2. Hi, I'll keep this short and to the point: State: OklahomaIssue: Insurance balance and potential of "balance billing" Background to Medical detail: (a) Surgery: Left sided Total Knee replacement (TKR) during March, 2011. (1) 1st TKR surgery done 3-15-11. (a) Post-Insurance balance, for surgery done 3-15-2011:...............$540 (2) 2nd TKR surgery done 3-30-2011 to "debride" infected knee (a) Post-Insurance balance, for surgery done 3-30-2011:...............$970 [original knee-prothesis was not deemed necessary to be replace with a clean prothesis] ....Balance claimed to be in "default":........................................................$1510 Notes: The balance of $540 under (1a) is a "Paid-in-full" account, and yes, easily documentable. The balance of $970 under (2a) is one I objected to, and remains the status quo for now. My Objection Rationale: I raised payment objections believing my EOB clearly stated Ive met all my medical cap obligations for the 2011 fiscal period and any further expenditures were a duplicate of the original. I didnt know what else to call it. Only later on, did I learn of properly paraphrasing it under the practices of "balance billing" and this issue was raised to both, the Hospital provider and the Insurance carrier. Hospital Administration admits they do balance billing. A quick reading of my EOB's from the first surgical date 3-15-2011, clearly states Ive reached my medical cap for claim year 2011 after Insurers paid the Hospital over 48K for this TKR experience so I find it hard to accept that my Insurance Carrier says the 2nd billing of $970 represents the reminder of my copayment being capped at that point. Enter "AMCOL SYSTEMS" to collect this amount of $1510 on 4-18-2013. (a) I issued a debt validation and a HIPPA authorization copy request on 5-10-2013 on 6-11-2013 I received from AMCOL in the mail: (1b) an Itemized statement listing all medical services rendered from the Surgical date 3-30-2011 and on. (this references the $970.00) (2b) An itemized statement listing all medical services rendered from the surgical date 3-15-2011 and on failed to materialize, from AMCOL. (This references the $540.00 part) (3b) AMCOL then proceeded to placed the amount of $1510.00 rather than the $970.00 that is in dispute over balance billing issues into the credit bureau files. I have NOT YET disputed this $$$ error to the credit bureaus. (Should I?) Question: If I dispute that the dollar amount of $1510 being reported and misrepresented by AMCOL to the credit bureau(s), would I have grounds for FDCPA violations against AMCOL and for FCBA violations against the hospital for providing a "paid up" account to a credit collector??..........(referencing the $540 that is paid up and yet end up in the hands of this CA. I thought "balance billing" was an outlawed activity, but seems to be a grey area, at least to my understanding. You may wonder how in the world did two accounts, for $540 and $970 respectively ever ended up in the hasnds of this collection agency??? Obviously, the hospital billing folks and the hospital accounts receivable folks arent communicating, they split my $540 between the two account balances so that it will look like Im paying on both of them at the same time instead of assigning the full $540 to the first account and arent responsive to my balance billing inquiries to get this correction made. To my way of thinking, I would think the first account with an ending balance of $540, can be easily and factually proved as being paid for in full, and is grounds for filing an FDCPA claim, in which case if AMCOL forks over $1k for this FDCPA error, I could then re-fork over that extra money to the hospital administrators and resolve the second account with an ending balance of $970 and end this balance billing feud. Or should I just report this to HIPPA violation to the proper authorities and forego an easy FDCPA violation (me thinks???) I'd appreciate being pointed out my weak arguments and how to strengthen this HIPPA quandry of mine. Thank you so much!!!
  3. I do hear ya on this matter, Coltfan, and my inexperience in this legal landmine doesn't want to get them enough rope to move for MSJ. Now I see if I do give them enough rope, the MSJ might be moved to the backburner, technically allowing me enough time to get in my arguments for SOL. This is counter-intuitive, where one, like myself, is taught to hold your cards close to your vest. Gonna work on those opening statements when I get my affirmative defense "ducks lined up " first. Will post that "revision" on this forum, here when draft is completed and its ready for further critical reviews. Roadie
  4. (a) taking the first one out, is beginning to make the responses less "snarkier" (ha). Nevertheless, paragraph has been modified. Several of you CIC'ers have pointed the same thing out, So Im taking the whole paragraph out instead of just that singular line, and now working on replacing placed it with another paragraph, fleshing it out with affirmative defenses listed in the "Answer-to-the-petition". This has been a valuable learning tool for "writing clearly, and writing well" with an eye to supporting my answers with either a citation or other document intended to be submitted into court. Roadie
  5. Changes incorporated!. Thank you for pointing that out. Roadie
  6. .... been getting that hammered into me lately! Helpful criticism certainly is well taken roadie
  7. Evidence? Nada. The only thing that came with the summons, originally, was the confounded "affidavit" which I attacked in the 'rogs submitted to Plaintiff.... I like the phrase "yet proven to exist". and will also add "denial" to make it a confirmed denial so it wont be inadvertently switched to an "admission". Im learning, everyone's making sure I don't play with those "cant confirm\cant deny" lines. Ive changed rog-2 to read as: (effective 4-5-2013) ...." Defendant states that Plaintiff's interrogatory #2 is of premature speculation in that it requests defendant, prior to completion of discovery to assume facts not in evidence and on an account that hasn't yet been proven to exist. Therefore Defendant Denies. " (I think that ones more helpful!.... thank you!) roadie
  8. Seadragon, that makes sense, from the perspective of "any vague answer" = the equivalent of "admitted". Ok, I fixed admission #2 to "denied", and Im thinking perhaps admission #4 should also be "denied" ? All those 4 denials then led to "rog-4", wanting me to "write the actual truth of the matter". Well, Coltfan's "I don't owe you a legal penny" makes sense (not in those words, I know, ha) About those "affirmatives" your mentioning, are you talking about "rog-6"?... if yes, then okay, makes sense not to let them have a reason to file an MSJ... I'll work on its revision, not sure how I'll word my affirmative defenses into this section but I have been put on notice and I'll fix it. Thanks for pointing this aspect out. roadie
  9. Coltfan, ya referring to "rog-2" when I mentioned premature speculation? Or to "rog-6" where theyre asking me about my defense plans at trial to be raised? ".... eh, "Im not legally liable to the Plaintiff"... short and sweet.... I'll consider adding those to ongoing revisions! roadie
  10. Spikey, I appreciate you pointing this out for "rog-6", at the moment, Im gonna stick my neck out and say "yes" but having legal inexperiences and sometimes a tired mind is grounds for double checking my Oklahoma Discovery code procedures. I'll doublecheck on this and get back to you. Again, appreciate pointing this out, as I said, I don't want to be shooting myself in the foot! ... and besides each critical query can only motivate me do a better job! roadie
  11. Hi, BV... (a) Fixed #3... regarding 'rog-2'..."premature speculation"... this question is being asked prior to completion of discovery so isn't that grounds for "premature speculation" until Midland's lawyers answer my Rogs\Admissions\RFPD's? [c] regarding "rog-4".... so I just use the same paragraphs Ive employed in the Admissions section? and leave it at that? I thought the rog-4 wanted me to explain to them my "show me the evidence " position [ Why? Cuz my OC is still reporting a balance instead of $0" ] and Midland states they bought the account almost a year ago so me thinks the OC had time enough to zero out the balance. Knowing you've got keener senses, Im taking another look at revising rog-4... its kind of like walking in a minefield with Rog-4 [d] oops... for rog-5, ... that one was an error, I shouldn't have said "client", I meant the Plaintiff's lawyers that is to say, If the two [Midland and Midland's Lawyers, Love, Beal and Nixon ] aren't communicating, then Im treating that Rog-5 query as duplicative.
  12. Holy cow!... this situation is similar to the one being faced in Oklahoma where the SOL isn't quite so clear (cant find caselaw to buffer against Midland, but ColtFan's approach is what Im looking for, too. IM gonna pirate some of this and drill it into my head to shift the issue away from "written contract". Ive got potential problems with that too, as Bruno kindly pointed out to me earlier last week. Roadie
  13. Common sense would speak to that fact, indeedy Note: Today, Wednesday, April 3, 2013, I went back into page one to take out the "old" answers of the discovery set intended to be sent to Plaintiff (Midland)... the new "answers" are now online for evaluation and assessment, will you guys please see if Im shooting myself in the foot? By the way, Discovery has to be completed by April 15 according to scheduling orders, so I presume I'll send out this weekend if assessment here goes well. Thanks, everyone. Roadie
  14. Hi SeaDragon, point taken... I was playing it close to the vest as you pointed out, but that's because the law office of L.B.N. are equally dirty (my consumer perception speaking out) But more to the point, IM letting everyone know IM spending today (Easter Sunday, ha) taking out the objections, and revising my answers (while maintaining the truth, of course) I can already see I have a few sticky points, example: How to answer the question "did you obtain credit on the account referenced in petition"....petition is referencing "Dell's" account number Hmmmm. Im sure I'll come across something similar, somewhere here to provide the law office of LBN an answer. When I come across some sticking points, I'll bring those in one at a time to this forum's readers before releasing the final revision for interested parties to chime in. Speaking of which, how do I "delete" the original discovery set and replace it with the revised version? This way, the version with objections in it, wont inadvertently mislead future readers who are ending up in the same boat I am in? roadie
  15. Thank you, Nascar, Tulsa, Okla is two hours north of me. Im keeping this reference. I have sent him an email to this effect. Roadie