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beating my head against the wall with paid medical


hunterduke
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as many others here i paid a medical collection without really knowing my dv rights

here i am three years later still trying to remove a "paid" medical collection

heres the short of it.

the dr failed to submit to the insurance company (it was a covered expense)

it was sent to collections

i tried to talk to the finance people at the drs office and was essentially told to FOAD

i ended up paying the bill to the collection agency, i told them it was a covered expense but they also gave me the FOAD

its my only derogatory on my credit report

and on top of it transunion reports it as paid in full but also as "open"

i have disputed this tradeline atleast 3x with each agency and it always comes back as verified.

I recently filed a complaint with the BBB

here was my complaint

had a bill from my sons dr for 144 dollars sent "collection agency" for collection on 9/04.

this account never should have been in collections because i had discovered that it was an error from the drs office they had incorrectly submitted the claim to my insurance company. I tried explaining this to nh collections to no avail so i ended up paying the 144 dollars. so not only did i suffer damages from having to pay a covered expence but nh/northeast collections is reporting a bad tradeline on my credit reports and refuse to remove it. it also is inaccuratly reporting it as "open" with transunion even though it was "paid" and "closed" I have disputed this innacuracy several times with transunion but it always comes back as verified from the credit reporting agency.

i have suffered with this innacuracy for several years i have not only been denied credit but also have to pay higher interest rates due to this inaccurate negative trade line

here was their reply

basically again i was told to FOAD

here is their rebuttal all in caps no less

RESPONSE: IN RESPONSE TO "stupid consumers" COMPLAINT NEVER IN ALL THE

CONVERSATIONS WITH US MENTIONED INSURANCE. NEVER CONTACTED OUR CLIENT WITH INSURANCE EITHER. PROMISED TO PAY THE BALANCE ON THE ACCOUNT OVER A 2 MONTH PERIOD AFTER THE ACCOUNT HAD ALREADY BEEN WITH OUR OFFICE FOR

6 MONTHS. RECEIVED ALL OUR LETTERS INCLUDING THE INITIAL DUNNING NOTICE WHICH EXPLAINED the RIGHT TO DISPUT THE DEBT AND DEMAND VALIDATION OF THE DEBT. the ADDRESS HAS NOT CHANGED AND WE NEVER RECEIVED ANY MAIL RETURNED . THE DISPUTE LIES WITH THE INDIVIDUAL CREDIT BUREAU THAT IS INACCURATELY REPORTING THE INFORMATION ON THE CREDIT REPORT. WE ELECTRONICALLY SUBMIT TO ALL THE BUREAUS EQUIFAX, EXPERIAN AND TRANS UNION.

IT IS OBVIOUS THAT WE DID FULLFILL OUR OBLIGUATION IN UPDATING THE CREDIT REPORT BECAUSE ONLY HAS ONE CREDIT BUREAU REPORTING IT INCORRECTLY. IF THEY VERIFIED THE DISPUTE WITH US THAY WOULD HAVE THE CONCUMER DISPUTE VERIFICATION FORM WITH MY SIGNATURE ON IT WHICH NEEDS TO REQUEST FROM THEM. THERE IS NOTHING FURTHER WE CAN DO BUT DOES NEED TO DISPUTE THE ITEM WITH THE CREDIT BUREAU IN QUESTION AS IT WILL REMAIN ON the REPORT AS A PAID IN FULL ACCOUNT.

Heres is my rebuttal to the rebuttal

The consumer indicated he/she DID NOT accept the response from the business.)

I did infact have a telephone conversation that this item was covered by insurance. they simply did not care. i paid the item in hopes of clearing this up with my sons primary health physician, they however were uncooperative in the matter and said that since it was turned over to collections that they could not help me. so i phoned my insurance company and they told me the problem was that the primary care physician failed to submit the claim.I honestly believed that since this billing error was no fault of my own that it would be taken care of by all of the businesses involved...sadly i was wrong in that assumption.

I have not lied about this being reported incorrectly, i stated it was incorrect on one report, i have disputed with the credit reporting agencies THREE times and the innacurate information came back as VERIFIED every time

this is a violation of the fair credit reporting act this collection agency has been paid by me for someone elses mistake and i continue to suffer. I hope to resolve this amicably with them

I have all the the medical tranactions for that year that show that i was indeed covered consistantly before and after this one error and If the submission of this information would help to remove this trade line i would be more than happy to send it to them.

I admit i did not know my rights to dispute when i recieved this Dunning letter because i never had this problem with my insurance before and have not had any problem since.

I do hope that this will serve as a letter of good will to resolve this, my intention is not to do this company any harm..I am in fact the only one who has been harmed by this error. Im just a hard working parent who pays a huge insurance premium and simply just wants to stop being punished for trying to follow the rules.

I am really annoyed that not only do i pay my insurance and pay my bills that im punished for paying a bill that should never have existed

they are outright lying that i never brought up insurance

quite the contrary to what they say i said i would pay it "stupidly" then try to clear it up with the insurance company

they were all for this idea and even encouraged me to do so.

i have no idea what to try next or just live with this miscarraige of justice for years to come

probably will never get a delete now that i complained to the bbb

just venting i guess

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Hi there,

I work in HR and just wanted to let you know that if you have a medical bill that is not paid or paid incorrectly by your insurance it's your responsibility to straighten out with the insurance, it's not the provider's responsibility.

When you sign the form at the provider's office it states that you are liable for paying what the insurance doesn't, so I see where they are coming from on that end. You should have rec'd an EOB explaining the payment of charges.

Just wanted you to be alert in the future that it's you that has to follow up with the insurance company so that you don't run into this in the future.

Sorry for your experience!

Donna

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thank you dona for your reply,

however that isnt what happened...my insurance company would have been more than happy to pay IF THE DR HAD SUBMITTED IT

i missed this because i never had this issue before and i know my only fault was not looking at bills i assumed were paid (lesson learned)

every bill before this one was submitted and paid

and every bill after this one was submitted and paid

my children have been using this dr for almost 8 years i would just think that someone somewhere would say

hey

why does hunterduke have to be punished for 7 years for a billing mistake

or do i simply have to bend over and take it for 4 more years

seems no one cares about good will anymore

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Irregardless if you have a paid medical it appears there is hope.

Check out this site http://whychat.5u.com/hipltr.html

Read the information carefully

I am in the process of using it at the moment as I have a paid medical on my CR as well.

It appears it only works for paid though.

Once the medical bill is paid there is no permissable purpose for it to be on your CR and the OC must pull it back and have it removed is my understanding The CA is not responsible under HIPPA but the OC is

Moriah

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that is correct

eq and exp show "paid" and "closed"

"tu" says "paid" and "open"

i have disputed the "open" time and time again to no avail

i guess i wouldnt be so angry if this bill was truly owed by me

i paid it even though the simple fact is this bill should never have existed in the first place

and all i did was make things worse for myself

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Hi Moriah,

It works the same for something not submitted. If you get the bill from the doctor and it's not paid or you do not receive an EOB then you have to call the insurance company to confirm it hasn't been submitted. If it isn't you have to call the doctor and tell them to submit it for payment.

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Donna

i did call the drs office to inquire about this bill and they flat out refused to offer me any information on it..ultimatly my insurance company was able to provide the information that the bill was simply never submitted.

when i called the drs office back with this information they refused to recall the debt from the ca, not only that she insisted becomming rude with me and giving me 100 reasons why it was all my fault.

im not sure of that hippa letter

the debt did exist

just shouldnt have been my debt

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Wow! That sucks!

Maybe you should contact the doctor yourself?

My husband had a run-in with someone in billing once who was very rude to him and we faxed the doctor.

The lady was fired the next week and the person REALLY in charge called him and told him they were very sorry about what happened.

He and the doctor had an established relationship and the doctor didn't like the treatment my husband got. Wouldn't hurt since you say you have used this doc for a while...

Donna

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that is correct

eq and exp show "paid" and "closed"

"tu" says "paid" and "open"

i have disputed the "open" time and time again to no avail

i guess i wouldnt be so angry if this bill was truly owed by me

i paid it even though the simple fact is this bill should never have existed in the first place

and all i did was make things worse for myself

To be honest, a three or four year old collection prob has little, if any impact on your score. However, if you really want to get it removed, try this:

Dispute the TL with TU again. If it comes back as verified;

Go to your local small claims court or look them up on-line. Get the official court forms you need to file a complaint. Write the complaint. Send a copy of the complaint along with an ITS letter. Include a settlement offer in the ITS letter. Give them sufficient time to reply.

They have already admited that they know about the reporting error...

Here is the law to cite;

FCRA § 623. Responsibilities of furnishers of information to consumer reporting agencies [15 U.S.C. § 1681s-2]

(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 has reasonable cause to believe that the information is inaccurate.

(B) Reporting information after notice and confirmation of errors. A person shall not furnish information relating to a consumer to any consumer reporting agency if

(i) the person has been notified by the consumer, at the address specified by the person for such notices, that specific information is inaccurate; and

(ii) the information is, in fact, inaccurate

Even if they fix the error now, it's to late, they violated. At the very least, demand they remove the TL. If they iognore you, file the complaint with the court.

-r

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Your issue is with the medical provider. Since you have seen this physician for almost 8 years, he/she may be distressed at the prospect of losing you as a customer. I recommend that you approach it from that angle. Forget the staff and contact the doctor directly. Make an appointment and pay to speak to him if necessary.

Yes, the bill properly existed and it was your 100% responsibility to pay it. But now that you have...would be good will on the Doctor's part to recall all records from their CA so that this will not be verified in response to all future disputes. No harm in using HIPPA as justification.

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thanks for the support and the ideas.

I will try the dr first, then if thats a dead end i will try the ITS with the CA

i just wish that everyone i dealt with on this (CA AND billing office)didnt make me feel like dirt for havng this go to collections when my only offense was believing people were going to do their jobs

oh well..live and learn

I will keep you all posted

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hunterduke, I feel your frustrations. You do sign a thing saying you are responsible blah blah blah... but like you said, THEY failed to file. I had the EXACT same problem as you. A provider had failed to file on our insurance when my wife was in the hospital... they tried to file 5 months later, insurance rejects, they send me a bill for $700. I fought it and after 6 months they relented and agreed it was their fault, but it took a threat of a lawsuit.

The other posters are right to a degree, that you are responsible. HOWEVER, if you see an in-network doctor, they have a contractual obligation with your insurance company. There are many stipulations in this contract, INCLUDING that they file their claims on a timely basis. Failing to do this will result in non-payment from your insurance company. Most insurance companies give them 60-90 days after the date of service. However, I've seen my insurance company pay for a claim that was a year old! haha. Of course, they did file originally, but they misfiled, so that may be a little different as it was a correction.

Anyway, my wife worked in claims at a major insurance company so she knows the ins and outs and how to deal with them. You should NOT have had to pay. If the doctor is in-network, they have a contractual obligation to file timely claims against the insurance company. If they are out of network, then they don't have to follow those rules. Believe me, it was a pain. I got advice from my insurance company. I wrote the provider a FOAD letter 3 times then they finally said that they were no longer pursuing any collections against me. Fact is, they have a contractual obligation to live up to. You are responsible for the claim if your insurance denies it or underpays or whatever, BUT as an in-network provider, they have a responsibility to file that claim. If they don't, they have failed to live up to their end of the contract and IMO (as I'm not a lawyer), they have forfeited the money the insurance company would have paid.

But it did work for me and I refused to pay. They ate the cost.

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Razr - Thanks for posting the paragraph. Looks like I will be needing that pretty soon.

Duke - Good Luck with this, I have similar situation where the DR's office failed to send me the balance owed after INS paid. Instead, they sent it to some blood sucking leeches that call themselves a collection agency.

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just an update,

The bbb has given them till sept 30th to respond to my response about this.

meanwhile i called the drs billing office yesterday and asked to have the information pulled back from the collection agency to protect my privacy (hippa thing) anyway she could not find any records in my file of any debt for the amount i owed (144.00) being sent to collections in 2004

i cannot find the bill so i dont know the specific account number associated with it.

she transfered me to her supervisor but i got dumped into the voice mail.

im thinking that this will be my new course of action

first i am going to wait for the new bbb response, if its unfavorable i am going to sent the CA a DV based on the drs office having no record of this debt and ask them to prove it even existed..and if not to refund my money and remove from my report.

if they can infact verify the debt by sending me the drs bill, i will then in turn have the information i need to send the hippa letter to the dr asking them to recall my documents from the CA.

if that proves successful i will once again dispute with the big 3

if it comes back verified again, i will proceed with an ITS letter.

i do understand that this collection isnt effecting my score much (my problem is maxed out credit limits) but it just irks me since its the only negative trade line i have and it will be years still untill it falls off.

just looking for feedback on my plan of action

any advice would be appreciated

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I have decided to add this additional information to my BBB Complaint

It may come off as a tad babbling and Nutcase

But I really want to know what information they have before i take any other course of action..if i have to wait 4 more years for this to come off my report then at the very least i want to make them suffer along with me for the whole ride!!!

Now Im aware that the HIPPA speil is intended for the Drs Office Not The CA but i figured it was worth a shot.

I called the billing department of the hospital for more information and an account number and date of service on this alleged debt yesterday 9/19/07they were unable to find any record of any debt in the amount of 144 dollars going to this collection agency. I now find myself questioning if this debt i paid was indeed my responsibility at all.I would appreciate cooperation from nh/ncs in providing me with copies of all documentation of this debt. Since this is medical related i have great concern of what records were provided pertaining this debt and want to ensure that my HIPPA rights are not being violated since NH/NCS is not entitled to sensitive medical information In addition, the HIPAA and New Hampshires's Medical Privacy Statutes are in effect in this situation even though the health care services 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.Subsequent reporting of this account on my credit reports 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.Unless this matter is settled to my satisfaction I Have no intention on letting this matter drop. cooperation would be appreciated

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Well they just responded to the BBB again with this garbage

RESPONSE: Hunterduke admits he received the initial dunning notice which

explained his rights to to dispute this claim or request validation of the claim but chose not to do so but to pay the account over a period of time. Hunter was also given the Mini Miranda during our first phone conversation . Our position remains the same. The account is correctly reported to the three major credit bureaus as a paid in full collection account. We have not violated any laws nor regulations governing the collection of a debt or the F.C.R.A.

I have not accepted this answer

here is my reply

I know nothing about a mini miranda,

I request proof of this allegation.

The fact is I was encouraged by representative to just pay and straighten it out later, I had never had an account in collections before and had no way of knowing that straightening this out would prove impossible. They were pleasant on the phone and I had no idea that they were lying to me about this being able to be straightened out. I guess they are only cooperative until they get paid.

My last dispute for the INCORRECT tradeline from this company just came back as VERIFIED last week for the 3RD time..at this point they are in violation of the F.C.R.A. contrary to what they claim. I will be esculationg this complaint to the attorney general of consumer affairs and the FTC if I again recieve no cooperation on the validation of this debt. AGAIN I stress that the DRS.office and /or hospital has NO RECORD OF THIS DEBT!!!! My insurance company shows NO RECORDS OF THIS BILL!!! Just because I took them to their word and failed to ask for validation of this debt does not mean that they get to keep money from me that may not be theirs to have.

I have a right to know what records they have pertaining this collection. This is a medical bill and My privacy rights under the HIPPA laws need to be protected. All i ask for at this time if for them to Validate this debt to me by sending me the following

What the money you say I owed is for.

Explain and show me how you calculated what you say I owed

Provide me with copies of any papers that show I agreed to pay what you say I owed

Identify the original creditor and account number and a copy of the bill with date of service

This is all I ask for at this time from them and I do not feel it is an unreasonable request. If they cannot send this information to me Then I demand to know how they can continue to verify this information to the credit angencies.

The fact that they continue to report inaccuratly is in fact a violation contrary to what they claim and when and if all negotiations fail I do intend to sue for damages

Opinions?/

I have 4 more years to torture them and I plan to!!!

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why not mention hipaa? I have been looking into it and there is supposedly a clause that says they can share information as long as it is needed for business (to collect money), BUT since it is paid, then there is no need for business...

I am trying to find the actual words...

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my bbb case has been closed and they still wont even send me what information they have on me

here was their last reply...WHAT DO I DO NOW?

all i asked was for them to report properly and to send me validation

RESPONSE: hunter needs to understand that the amount our client placed

with us was for four different dates of service and were all balances after insurance as was already explained . The HIPAA Privacy Rule permits Health Plans and Providers to use Collection Agencies because debt collections is recognized as a payment activity within the definition of payment. It further states there is no conflict between the Privacy Rule and the F.D.C.P.A. when the use or disclosure of protected health information is necessary for the covered entity to fulfull a legal duty. The Privacy Rule would permit such use or disclosure as required by law. The Rule_defination of payment also includes disclosures to consumer credit reporting agencies. The Rule further states there is no conflict between the Privacy Rule and Legal Duties imposed on data furnishers by the Fair Credit Reporting Act. The New Hampshire Law reads the same as the HIPAA Rule. The Law is not only written to p rotect the consumer but it is also designed to protect companies such as New Hampshire/Northeast Credit Services, Inc from frivolous complaints being brought against them. In closing I would like to state that NH/NE Credit Services, Inc has performed according to the guide lines of the law and consider this matter closed therefore there will be no further communication with relation to it.

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I just Filed A complaint with the AG

I filed a complaint with the BBB due to innacurtate reporting of a tradeline with Transunion, I have disputed the innacurate information 3 times and xxxx credit service keeps verifying inaccurate information causing me excessive damage to my credit. This was for a past medical billing error that was no fault of my own. I have requested a debt Validation With xxxx credit due to the fact that the origional creditor had no information about this account and they REFUSE to send me any details of this PAID collection account. They even attack me stating that my complaint is friviolous. I Truly feel that i have a valid complaint and I really need help to get this company to send me the validation I requested. All I requested was Proof that this Bill I paid was Valid and Truly My Responsibility. I have attached all written communication with this company for your review

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  • 2 months later...

is it time for an ITS?

I filed a complaint with the AG after a long wait the CA finally responded once again they simply called my complaint unfounded and friviolous all im asking for is the information about this debt and for them to atleast report accuratly. since its a medical bill am i not entitled to know what information they have in their files?

They claim they verified the information with the credit bur. and the drs office and that everything is correct they also admit to verifying the information on my credit report atleast 3 times after my disputes

but guess what...my credit report is still innacurate

it shows the account as open and "derogatory" instead of "paid" they refuse to send me any information on this collection including an MOV the CRA of course telles me to contact the CA about the error but what can i do when the refuse to cooperate or send me anything?

Im thinking a ITS is my only option..do i have grounds for this?

any advice is greatly appreciated

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