PrincessAmy

I am DARING this CA to validate this debt!

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Long story short, a CA shows up on all 3 CRA's for a $100 ER copay to a hospital. I paid this directly to the hospital in May and have a copy of the printout showing that it was paid and I have a $0.00 balance. This is about the 3rd CA to try to collect on this, but I haven't received a dunning yet. The other one's I DV'd and they completely ceased collection activity and sold it off.

Got the DV ready in my CMRRR envelope to go out with the Arrow 623 letter tomorrow....

Come on - I HOPE they validate it - cause I need $1000 to pay tuition :)8-)

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I think by the time I'd already gone two rounds over this non-debt and now looking at a third, I'd be filing a nice, juicy lawsuit against the stupid, incompetent hospital and I don't mean for FDCPA violations, either.

Anyplace this stupid deserves to have their a$$ hauled into court to explain why they have placed a paid account with three different collectors and trashed your credit reports and caused you mental anguish, etc., etc.

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I think by the time I'd already gone two rounds over this non-debt and now looking at a third, I'd be filing a nice, juicy lawsuit against the stupid, incompetent hospital and I don't mean for FDCPA violations, either.

Anyplace this stupid deserves to have their a$$ hauled into court to explain why they have placed a paid account with three different collectors and trashed your credit reports and caused you mental anguish, etc., etc.

Let me wait until I pay them the othe $67 dollars that i owe them for my last ER copay in May then I'll go the lawsuit route. I want to make sure it is a specific account that they're placing on my credit file -the account # isn't the same as the hospital's account # - I need to see the Date of Service.

If so, I'll send a nastygram to the hospital. However, could I really get money out of them? On what violations, releasing PHI info?

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Let me wait until I pay them the othe $67 dollars that i owe them for my last ER copay in May then I'll go the lawsuit route. I want to make sure it is a specific account that they're placing on my credit file -the account # isn't the same as the hospital's account # - I need to see the Date of Service.

If so, I'll send a nastygram to the hospital. However, could I really get money out of them? On what violations, releasing PHI info?

IMAHO, you need get angry for their being incompetent, idiotic, assholes who send an non-existant debt to not just one but three different collection agencies...bad enough to have to deal with the likes of a CA on a debt you actually owe; to have to deal with three of them for a debt you don't owe is inexcusable...if they sold this debt and don't own in anymore; same thing...they had no right to sell a "debt" that didn't exist (in which case they have no only harmed you bur the debt buyer they sold it to).

Forget "violations" unless you have ironclad proof of them...get a good, hungry attorney (one who dislikes doctors/hospitals would be a plus) and sue them for whatever he can come up with (defamation, mental anguish, time lost from work dealing with the issue, attorney fees, whatever)...only by making businesses pay for their incompetence will they fix the problem.

As you can tell, I'm starting to get a real burr up my backside for incompetent medical providers and their billing offices.

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I agree with Robert. Get a good NACA lawyer and go for it. I'm going through the same thing now and am actually meeting with my lawyer tomorrow to go over the suit he's going to file and the complete game plan.

And for medical billers~ what online certificate did they get! I got billed last year for a bronchitis visit when it was actually a yearly physical and I couldn't get it through their thick skulls they billed me wrong and I had to pay them for a damn office visit! Arrggh!

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:complainer: The whole medical billing process is out of control and seemingly run by idiots.

When consumers actually do pay attention and try to know and understand what's going on, providers can't tell a consumer what they really owe them and what they owe for...when they do manage to provide detailed information (and list all the $10 aspirin they administered) you can almost always count on the data being wrong!

Unfortunately, consumers often don't pay attention both because it's so difficult to get information and because we are so far removed from the payment for most medical services by our insurance system, by the time we find out what didn't get billed properly or what our insurance didn't pay for or one lazy doctor finally submits his outrageous bill too late for our insurance to pay, it's usually too late to do anything about it except pay it out of pocket.

What is even worse is that much of the time our first indication of a problem is a CA contacting us and/or putting a negative tradeline on our bureaus.

All that to say...the only way to "encourage" these medical providers and their billing offices to clean up their act is to make them pay big $$$ for their mistakes until they finally come to the conclusion that it's less expensive for them to do it right in the first place than it is to pay for their mistakes later on. xhotx

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:evil::evil:I agree with Robert on this mess. I have had to fight a dang hospital twice in the last five years for incorrect coding or address issues leading to collections. Luckily by the time I had a full head of steam & contacted the collectors,they were more than happy to delete for payment in full just to get my ornery butt off the phone.8-):ROFLMAO2::ROFLMAO2::ROFLMAO2:
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The $67 is still owed to the hospital - they allow you to break your $100 copay into 3 monthly payments.

I guess break it down a bit...

Admitted to hospital 7/7/07 for Appendicitis - had appendix removed. They never formally admitted me, so I had to pay the $100 ER copay. I tried arguing it, but it didn't work.

Got letter from 1st CA in April - I sent check to the OC on May 15th with apologetic letter stating that it slipped my mind, blah blah blah. OC cashed check on June 16th and sent me a copy of the bill.

In between May 15th and June 16th, got letter from collection attorney - DV'd them and they went away.

Then in the past week I saw the 3rd CA pop up on my credit reports - sent off DV this week.

I guess I will get a nastygram prepared to the hospital for violation of HIPAA. Problem is, I don't know when they sold the debt to the CA, and if it's being passed around, etc. Will a NACA attorney even take it over a $100 debt?

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That’s a bit of different picture – I had the impression that there was never a bill owed (that it was paid initially when due). :|

First of all, I’m not sure I’d sit still for the “you weren’t formally admitted to the hospital” argument – that sounds like a purely administrative decision made to benefit the hospital and/or your insurance...if you were there overnight and/or for more than 24 hours than it would seem to me they “admitted” you whether they called it that or not…I’d argue that one in court. Therefore, if the charge was never legitimate in the first place then everything that followed was unnecessary and burdensome and caused damage to you and your credit history.

If the charge is legitimate, then it would seem to me that your only argument is the continued collection activity after you had already paid the bill.

I very much doubt that the hospital violated HIPPA rules – it’s my understanding that there is usually an agreement/arrangement between medical providers and collectors that allow information to be passed when it’s necessary to collect an account. However, if HIPPA was violated then by all means, go after them.

As to the amount of the bill and getting an attorney involved; the size of the bill is immaterial…what matters is the size of the damage award possible.

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They kept me in the 24 hour observation floor/unit for 3 days - I have the EOB from my health insurance that shows that I was in the hospital from 7/7/07-7/9/07. Even the nurse commented she wasn't sure why I wasn't moved out of that unit. I tried arguing it with the insurance company and the billing dept at the hospital but it didn't work out. Called to find out the balance and sent the hospital a check for $100.

(Ignore the $67, it's from my ER copay in May...I just don't want to owe ANYTHING to this hospital when I write a complaint).

According to True Credit (again, not 100% accurate) the CA got the account in 2/08, but I have never gotten a dunning - I got one from a collection attorney in Toledo (same city where the CA is). I DV'd them, never got a response.

I have a copy of the itemization from the hospital showing the payment and that a $0 balance is owed.

Should I write a letter first ot the hospital stating that this CA is reporting an invalid debt and violating HIPAA by having PHI on my CR's? I got a deletion on a paid collection for that.

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The $67 is still owed to the hospital - they allow you to break your $100 copay into 3 monthly payments.

I guess break it down a bit...

Admitted to hospital 7/7/07 for Appendicitis - had appendix removed. They never formally admitted me, so I had to pay the $100 ER copay. I tried arguing it, but it didn't work.

Got letter from 1st CA in April - I sent check to the OC on May 15th with apologetic letter stating that it slipped my mind, blah blah blah. OC cashed check on June 16th and sent me a copy of the bill.

In between May 15th and June 16th, got letter from collection attorney - DV'd them and they went away.

Then in the past week I saw the 3rd CA pop up on my credit reports - sent off DV this week.

I guess I will get a nastygram prepared to the hospital for violation of HIPAA. Problem is, I don't know when they sold the debt to the CA, and if it's being passed around, etc. Will a NACA attorney even take it over a $100 debt?

So you were admitted to have a procedure done and they charged you a co-pay? I know my question is irrelevant since you have already paid it but still..... Aren't co-pays just for ER and doctor visits? I know I pay co-pays only on those two occasions. If I have to have a procedure done, then I have to meet a deductible. But that amount would be based on your deductible, the cost of the procedure, and how much of your dedcutible you have already met for the year. I guess all insurance companies are different, but I still don't know why they would charge you a generic co-pay for a scheduled procedure. :confused:

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....

The more you explain, the more this hospital sounds like it is either incompetent or a scam…I don’t care what the “room” is called, if you are in the hospital for THREE days you are IN THE HOSPITAL and not there for an ER visit.

It’s probably too late now but I would have fought the insurance company decision in any way possible (using whatever appeals process they have, filing complaints with whatever state agency oversees insurance companies in your state, the BBB, etc) until someone decided to use some all too uncommon common sense.

The problem is only worsened by the hospital sending this to a CA – even after you paid the stupid bill you shouldn’t have owed in the first place.

I’d still find a good attorney and probably name the hospital, the CAs and your insurance company as defendants…simply filing the suit may make these idiots decided to do the right thing.

I'd let your "letter" be a summons to court.

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It wasn't a scheduled procedure, it was an emergency appendectomy.

Most hospitals have a 24 hour observation unit/extension of the ER. Moreso if you need more tests done or they want to make sure you're okay to go home. When I had surgery in January, I got the flu 2 days later and ripped my stitches. My doc kept me in the observation unit for 24 hours, but I wasn't admitted.

I have an HMO - no deductible.

I tried fighting the copay with the hospital and the insurance company. Insurance said that the hospital had to code it that I was admitted and they would waive it. Hospital said I wasn't admitted and they couldn't code it that way because it would be fraud. It was lose-lose for me.

I'll try to write a good letter in the next day or so and have you critique it.

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It wasn't a scheduled procedure, it was an emergency appendectomy.

Most hospitals have a 24 hour observation unit/extension of the ER. Moreso if you need more tests done or they want to make sure you're okay to go home. When I had surgery in January, I got the flu 2 days later and ripped my stitches. My doc kept me in the observation unit for 24 hours, but I wasn't admitted.

I have an HMO - no deductible.

I tried fighting the copay with the hospital and the insurance company. Insurance said that the hospital had to code it that I was admitted and they would waive it. Hospital said I wasn't admitted and they couldn't code it that way because it would be fraud. It was lose-lose for me.

I'll try to write a good letter in the next day or so and have you critique it.

Oh okay. I have BCBS PPO. Good luck!

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Okay, this is a rough draft. I incorporated some of Why Chat's HIPAA letter into this, along with details of my own case to make it more personal and not a form letter. Please critique, as all suggestions are welcome and wanted! :D

Dear Sir/Madam;

This letter is in reference to Account #xxxx for services provided to PrincessAmy from 7/8/07 to 7/10/07. I was in the hospital due to an emergency appendectomy. However I was never formally admitted and as such, I was billed a $100 Emergency Room copay. I talked to billing departments at both (my insurance provider) and Hospital, and (insurance provider) said that I should have been formally admitted and they would waive the $100 copay, however the billing department at the hospital stated that since I was never formally admitted, even though I stayed in the hospital 3 days (more than the maximum 24 hours in the observation unit), I was still liable for this. As you know, communication between insurance providers and hospitals takes time. I apologized for the late payment but I was trying to sort this matter out, as (insurance provider) did not make the insurance payment until 10/4/07. I do not feel that I should have had to pay this copay as a simple admission coding would have solved this problem, however due to the high standard of care and the concern to make sure that my credit would not be affected, I submitted payment.

I paid my $100 insurance copay to you on 5/14/08, and check #xx was cashed and credited to my account on 6/12/08. I received a copy of my account statement from you stating that I have a $0 balance on this account.

To my utter dismay, I received an alert from Trans Union, Equifax and Experian credit bureaus that I had a new collection account from UCB Collections reporting to my credit reports, with the original creditor as (hospital). I also have received a notice from an attorney’s office collecting for UCB Collections on this account. I have sent both a letter to validate the debt, as allowed under the Fair Debt Collection Practices Act. I have yet to receive a response to them.

Please be advised that under the Fair Credit Reporting Act, (15 U.S.C. § 1681 et seq) and, you may be held liable for the actions of UCB Collections. 15 U.S.C. § 1681 et seq states:

(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 consciously avoids knowing that the information is inaccurate. In addition, the HIPAA and Michigan's Medical Privacy Statutes are in effect in this situation. 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.

Your furnishing of my account information to UCB Collections is not in compliance with HIPAA, or Michigan's Privacy Act, and any subsequent reporting of this account on my credit reports to Trans Union, Equifax and Experian 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.

You are required under the FCRA and FACTA to accurately report the status of any account to the credit bureaus, and you are prohibited under the HIPAA and State privacy regulations from doing so on a PAID account, as there is no longer any permitted business purpose. Therefore I am requesting you promptly rescind all such account information furnished to UCB Collections and require them to purge their records of all reference to this account, and that you insure that any and all reporting of this account is immediately deleted from my credit reports. This request will resolve this problem entirely.

.

Please respond, in writing within 10 days that you are processing this request.

I am reserving the right, to take appropriate legal and civil action including reporting to any applicable regulatory authorities any lack of cooperation or compliance with this request.

I hereby waive my rights under HIPAA and any State Privacy Act for the single purpose of your transmission of this request and accompanying documentation in any required report you must make to your E &O insurance carrier.

Sincerely,

Me

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I've done something I don't usually never do - I've actually re-written your letter to "re-make" it in my own image. :)

This is my personal opinion of course, but I don't like sending a letter that makes me sound like an attorney when I'm not one...when it comes to quoting/referencing specific statutes, I like to leave that to real attorneys and the letters they write. I also believe that there is some value to not being "overly" specific as doing so can sometimes back you into a corner.

I also took out most of the verbage about HIPPA - I did that because I'm not sure, and I suspect your arn't 100% sure either, if they've really violated HIPPA statutes. I've also read recently that there is some sort of "special waver" that medical providers use with their CAs to specifically avoid HIPPA problems and unless you know that wasn't done here, I would be hesitant to make any absolute statements about that (which is why I mention it but in less "agressive" way).

Frankly, I think your original version was good so don't feel you have to use my suggestions...just consider them food for thought! :)

Re: Account No. XXXXX for Patient PrincessAmy; Service Dates: July 8th through 10th, 2007

Dear Sir/Madam;

I was in the hospital for an emergency appendectomy during the dates referenced above. However due to your facility’s administrative and arbitrary decision, I was never formally admitted and was consequently billed a $100 Emergency Room copayment. After becoming aware of this issue, which was some months after my surgery, I spoke to the billing departments at both (my insurance provider) and your facility. (My insurance provider) indicated that there was nothing they could do about the required copayment unless your facility changed its submission to show I was admitted. Your facility indicated that since they did not “formally” admit me, they would not change the way they were submitting the bill to my insurance provider.

To most reasonable people, anyone who is in the hospital for three days is IN the hospital; regardless of how a medical facility decided to "code" the matter for insurance. How your facility can justify calling it anything other than an "admission" is beyond understanding.

Your unreasonable and unjustified decision, and refusal to revers it, left me in a no-win situation and on June 12, 2008, after trying to sort this matter out, I made the $100 copayment (check #xx was cashed and credited to my account on June 12, 2008).

I regret the late payment but as I stated, I was trying to sort this matter out, - I did not even become aware or the problem until after (insurance provider) paid their portion of the bill (in October, 2007).

Thinking this unfortunate matter was settled, to my dismay, I received an alert from Trans Union, Equifax and Experian credit bureaus that I had a new collection account from UCB Collections reporting to my credit reports, with the original creditor as (hospital). I also have received a notice from an attorney’s office collecting for UCB Collections regarding this account. To be blunt, I fail to see any justification for your facility to have submitted this debt to a third-party collection agency, to damage my credit history and impugn my reputation; especially considering that the account that has already been paid in full!

It is my understanding of both Federal and Michigan law that you can be held liable for the actions of third-party collectors that you retain; clearly, furnishing inaccurate information to credit bureaus is prohibited and attempting to collect a debt that does not exist is prohibited and such actions can result in serious financial consequences. In addition, I believe you may also have violated HIPAA and Michigan's Medical Privacy Statutes.

I am requesting you immediately rescind all account information furnished to UCB Collections and require them to purge their records of all reference to this account, and that you insure that any and all reporting of this account is immediately deleted from my credit reports. This request will resolve this problem entirely.

.

Please respond, in writing within 10 days that you are processing this request.

I am reserving the right, to take appropriate legal and civil action including reporting to any applicable regulatory authorities any lack of cooperation or compliance with this request.

I hereby waive my rights under HIPAA and any State Privacy Act for the single purpose of your transmission of this request and accompanying documentation in any required report you must make to your E&O insurance carrier.

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I like your letter.

Your reference to FCRA 623(a) needs a little work. That subsection is only enforceable by the FTC and your AG, so you need to make it clear that you will be filing complaints with them.

The exception to HIPAA Robert_Nashville is referring to so that hospitals can disclose medical info and use CAs has to do with information related to the collection of a debt. The moment there is no more debt, their permissible purpose goes away and HIPAA kicks in.

I would add something about why should I pay for the actions of an incompetent admissions clerk, but that's just me...

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Thank you so much Robert - I like that letter.

cjtx is right - my understanding under HIPAA is once there is no debt, their right to report PHI to CA's is ceased.

One reason I don't want to be overly b**chy in this letter is that I may have to do some of my nursing clinicals at this hospital, and they also allow graduate nurses to work before passing the NCLEX (I start the RN program at my school in August). So I don't want to burn bridges, but want to get my credit corrected by something that is obviously wrong. This hospital is part of a huge medical group/hospital in metro Detroit.

Should I go ahead and send out the letter now, or wait to see if the CA validates the debt?

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Hmmm..

I got a letter from the CA stating that they show my account as Paid in Full as of 6/16/08 (DUH) and that the letter they sent me states that the account has been satisfied.

I guess I'll fire off another letter stating that this better be removed from all 3 CRA's as they 1) have no PP to report PHI since the debt has been satisfied and 2) they weren't even paid, the hospital was the one paid and cashed the check.

UGH!

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