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Please read and advise! being sued! need help!


workingitout
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Ok please give me feedback! Here is my case: I had various medical bills with local hospital. total $1100. about $300 were valid; co-pays for surgery. All the rest were amount the the hospital never billed my insurance co. for. Then they turned each bill over to a CA (there were 7 total). CA called me, I told them about the insurance, gave them info to bill ins. co. some time passed, my dad had cancer and died, didnt even think about it. Then I get a letter from attorney on 9-24-04. States all bills combined and has proper DV notices, etc. This time I send a request in writing (not certified) and in response I get a letter "pursuant to your request this is the proof" and all it is seven copies of"statement of accounts" from hospital It was just under 30 days. I was preparing to send another letter, (this time certified) to request ACTUAL DV, not BS. Before I got around to it, I am served with papers. He filed on 10-28. :( I didnt know then about the whole scope of the FDCPA, as far as the fact that failure to follow it is a defense against the atty's right to bring action. I went to pre-trial hearing, the judge took us in chambers, we talked, I explained my side, the lawyer was like "oh well, too bad, pay it - I am not settling this". I said I would settle for more than I actually owed to have it over with (like half) but the lawyer just told the judge he would be filing a motion for summary disposition. She was like "OK" and set a trial date for 4-18 and I got papers in the mail.

OK sorry so lengthy here is my question: :?: Do I have grounds to ask for a dismissal based on the fact that he never provided actual DV just some copies of bills? There was no affadavit, no payment history or anyting, it was very informal. I would like to move for dismissal and counterclaim for $1000 for violation as well. Can I do this? :?:

PLEASE any advice would be so appreciated!!!!!! :!:

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First of all, you must understand that YOU are responsible for paying the medical bills, regardless of whether or not you have insurance. Every practice and facility has it clearly posted that payment is due when services are rendered. They only file insurance claims for you AS A COURTESY. If these should have been paid by insurance, then you should have followed up with the insurance company to MAKE SURE the claims were submitted - NOT rely on the hospital to do it. That was your first mistake.

You won't get the case dismissed by claiming inadequate validation, all the other side needs is a 'preponderance of evidence' to convince a judge and 7 bills is definitely enough for a judge.

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I can't answer the legal questions about dismissal but I can tell you this much. Call your insurance company ASAP and ask for all records regarding the claim. Specifically, what charges were billed to the insurance and if any bills weren't paid what was the reason (billed with wrong code, bill was too old, etc.). Also ask for a copy of the contract between the insurance company and the medical provider.

Here's the key, if the bills weren't paid due to an error on the provider's part in not billing correctly that's any issue between those two. Proof of improper billing on their part means they cannot come after you for payment. The other is the contract. Some providers will come after a person for the total amount the insurance doesn't cover. If your carrier has a policy where the provider is only allowed say, the deductible or a co-pay they have just broken the contract. Insurance companies don't like that BS. Depending on how bad the violation is the insurance company might help you resolve this matter with the provider.

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First of all, you must understand that YOU are responsible for paying the medical bills, regardless of whether or not you have insurance. Every practice and facility has it clearly posted that payment is due when services are rendered. They only file insurance claims for you AS A COURTESY. If these should have been paid by insurance, then you should have followed up with the insurance company to MAKE SURE the claims were submitted - NOT rely on the hospital to do it. That was your first mistake.

You won't get the case dismissed by claiming inadequate validation, all the other side needs is a 'preponderance of evidence' to convince a judge and 7 bills is definitely enough for a judge.

Your'e right it's my fault, I kinda already admitted to that and said the reason why was my dad was sick and died (pancreatic cancer) all within five months... but anyway while I agree I had a responsibility, as did the hospital (that they didnt fulfill) I am more concerned with the lack of validation on the attorney's part. The thing is, if the orginal CA or the attorney had done what they should have and billed the insuance agency, it would have been within the one year claim limitation and all I would owe woudl be $300 which isn't a problem. I guess what I was hoping was that due to his lack of proper verification I could have some kind of defense. There isnt much else I could do, I wanted to at least have something that would give me some bargaining power instead of just rolling over... thought that was the point of this site. He also submitted to the court billing statements that show my personal medical info. I don't think that is legal under HIPPA. I just think it sucks that CA's and attorneys would rather prey on people than get the money where they should, from the fat cat insurance companies. But that's just my opinion. Obviously, you think otherwise.

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I can't answer the legal questions about dismissal but I can tell you this much. Call your insurance company ASAP and ask for all records regarding the claim. Specifically, what charges were billed to the insurance and if any bills weren't paid what was the reason (billed with wrong code, bill was too old, etc.). Also ask for a copy of the contract between the insurance company and the medical provider.

Here's the key, if the bills weren't paid due to an error on the provider's part in not billing correctly that's any issue between those two. Proof of improper billing on their part means they cannot come after you for payment. The other is the contract. Some providers will come after a person for the total amount the insurance doesn't cover. If your carrier has a policy where the provider is only allowed say, the deductible or a co-pay they have just broken the contract. Insurance companies don't like that BS. Depending on how bad the violation is the insurance company might help you resolve this matter with the provider.

I really appreciate your help - I am going tho call the insurance company again because I know that provider has a contract. The insurance company previously told me what you just did, that it was the provider's problem, but that was after I was filed against and also the judge and atty were very dismissive of that idea. So I had kind of given up on it. Also I didnt say earlier, some of the bills were miscoded- they were billed, but the code was for an ER visit instead of urgent care, etc. and it changed my copay drastically. Thanks again, I will check into this.

Still waiting to hear if I can or can't sue based on the crappy verification? Shouldnt he at least have provided me with the waiver I signed or something? Anyone?

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