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Medical collection and HIPPA letter


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My wife had surgery 4/10/2002..(I have an hmo)I thought all charges were taken care of . In May of 2003 I checked my credit reports and there was a United Revinue Corp collection account for Radiology Associates for 159.00.It took two weeks to find out that Radiology Associates didnt put the incorrect pre fix code on my account #.I was told that if I paid it that it would come out of collections.Well guess what.They took off the 159.00 .Now shows 0 ballance and a 90 day late collection account on EX. This is totally unfair. What do I do ???

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I can only assume by your post that Radiology Associates did not properly file their claim with your insurance company, therefore the claim was denied. Is this true?

Call your insurance company and ask if the claim was denied due to their not filing properly. If the answer is yes, ask them if you are liable for the bill. Reason being is that a lot of insurance companies write into their contracts certain limitations with the provider. Some of them are that the provider agrees to never bill the consumer more than the allowable amount. If the claim is denied asking for more info, such as, wrong code, knowledge of other insurance, are some other reasons, the provider is obligated to obtain that info and resubmit the claim within the parameters of their contract. If they fail to do so, they are to write off and never bill the consumer. Find all of this out. If this is true of your insurance, you can fight the fact that it should never have gone to collection. Also, your insurance company may have its own "collection" unit that gets involved in these issues. Get the answers and come back and let us know.

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Thanks for the reply...The lady at my HMO told me RA put the wrong prefix code on my account #. My policy is my ss # with a three letter prefix (sea) . My HMO sent the claim back to RA with instructions on how to file the claim properly. Thats where the trail ends untill it showed up on my experidan 5/2003.It sent my FICO from 660 to 614 .Out of frustration I gave RA my credit card # so they would get paid and I could get this off my credit report . They said it would come off EX completely .This looks like a mistake for me to pay them because I now have a paid collection 90 days late on EX and my FICO is 629. I recieved a statement from my HMO that it is past the SOL for them to pay the claim (but I have paid it )I am presently writing a complaint letter w/documentation to send to the BBB,Atorney General of Texas.Office of consumer affairs and the CEO of radiology associates. In other words I'm going to be a pain in everybodys a$$ untill this comes of my CR. Stay tuned...... B. Henry

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That is the right attitude to have. Go for the big one.

If I were you, I would see if your insurance does have a collection unit and if they will help you. If not, see if they will send a letter confirming the circumstances and clarify that the error was not your fault and the item should never have gone to collection. Your main goal is to get your money back and all negative info removed from your files. It is clear that you were never liable for this bill due to their incompetence and negligence. Once you have this info or some way to prove the liability, use it for all it's worth.

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