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Paid medical bill sent to collections


applegirl
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My husband had a test done at a local hospital in September 2002, and according to the EOB from our insurance company, he owed about $20.00 to the imaging center. We got the bill in November 2002, it was paid, and we thought that was the end of it. Then in October 2003, we get a new bill from the imaging center for about $50.00. I pull out the ole EOB and paid bill (I keep all this stuff after being screwed around by insurance in the past) and give the place a call. They tell me that the bill should not have been sent, to throw it away, and that they would correct it on their end. I document this conversation, but everything together, and keep it just in case. Then in December 2003, we get another copy of the same bill. :roll: I call them again, and they tell me that this amount is the difference in the contracted amount between their company and my insurance company, and that it is not our responsibilty to pay.

Today, in the mail, there is a notice from a collection agency for this same $50.00 that we supposedly don't owe. Since calling the imaging center in the past has obviously not taken care of this problem, I'm not sure what my reaction should be this time. Any suggestions?

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Send this CA all copies of your EOB's, black out any codes (see below), and a copy of your cancelled check. Explain to them you are not liable for the debt. It is very clear to all providers and CA's that a beneficiary is not liable for any amount other than the "Copay" or" Patient Responsibility" on an EOB. Also, show the proof you have as to the previous conversations with the provider, including names dates, etc. of each call and what was relayed to you by their employee. At the same time, call your carrier and explain this to them. they should have a department that assists in this type of matter. One question you will ask them is about charges not accepted as you described. One thing to point out to you is some agreements between providers and carriers include the verbiage that a beneifciary is only liable for some "denied" serivces if, and only if, the beneficiary signs an agreement prior to the service being performed. Otherwise, they cannot bill the beneificary. So, I say again, call your carrier and ask them all there is to know about the rules and regulations regarding "accepting assignment" with them.

Why I say to black out any codes is you want to protect yourself under the HIPPAA law. No one, especisally a CA, has no legal right to have access to these numbers. An example would be, the EOB shows a set of numbers that relates to a particular service, these are the ones you black out. The name of the place, in itself, offers the type of services available, but, the personal is what matters. As to the dates, charges, names, addresses, etc. leave them there.

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You're Welcome!

Just want to add that you could send a letter to the OC clearly stating the current situation and that you are so upset as to how they have treated you, blah, blah. You will also include that you are now involving your carrier and have all intentions of pursuing any and all avenues available to you in getting this resolved amicably. This includes filing complaints wiht the BBB, AMA, AG, FTC, and any and all governing agencies as you will not tolerate this type of action. You will advise them they can be held liable for the actions of their assignee. Also include verbiage that you are now researching the new HIPPAA Laws and that any and all information recieved will be used to determine if there are any violations of the HIPPAA Law as you will most definitely file the proper complaints. You also retain all rights afforded you in resolving this matter, including, but, not limited to, naming them as a defendant in a Civil Suit.

With the HIPPAA still somewhat new, many providers are so afraid of it, they crawl into a hole and hide. Basically, what it says, is if your personal Medical History gets into the wrong hands due to their actions, they can be fined big time. I think the first time is $5000.00, then on up after that.

For the simple reason of the HIPPAA, you will clearly state in your letter to the CA that you retain all rights under HIPPAA as your letter is not a request for validation, it is absolute proof you are not liable for the debt. therefore, you will waive your rights for the one time contact to assure this alleged debt is cancelled. Go to around Page 30 of this section and look for the thread titled "????? About HIPPAA - - ". You want to find the letters to use when sending to the OC's.

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