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Multiple questions regarding medical collections


buckeyechick1219
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When I had my daughter two and a half years ago, I applied for financial assistance from the hospital. While they were taking their sweet time processing it, I sent in payments of $25-$50 per month. I started receiving harrassing phone calls from their collection department (at the hospital) telling me I had to pay the balance in full for myself and my daughters outstanding bills and I would be reimbursed for any expenses covered by the financial assistance. I told them fat chance that I would ever see a dime of reimbursement after they had my money in hand, so they threatened to send me to collections. I continued to send monthly payments until I got notice that they had sent my account to PCB. I disputed with PCB and they supposedly returned the account to the hospital. I've heard nothing for over two years now, and there was no record of me even having an open account with the hospital when I tried to pay it.

Fast foward to this past year when I had my son. I applied again for financial assistance because my insurance didnt cover anything. Again I received harrassing phone calls, and knowing that last time they DID send my account to collections even while I was making payments, I paid the balance in full and waited for a refund. After several months of waiting for repayment (I paid the balance in November) I sent a letter to the hospital telling them "Per the recent statement you sent me, I was eligible for financial assistance. Your collections consultant ***** said that I would be reimbursed for all covered expenses once the application was processed. According to your statement, 65% of my medical expenses were covered by financial charity and I am therefore due a refund of $*** which I have not yet received." I asked for a response and sent the letter at the beginning of March.

I have not received a response from the hospital, however, this week I received a collection notice from a different collection agency for the balance due on my bills from when my daughter was born. I definitely plan to request DV, but I'm thinking I will wait until day 28 or 29 to give myself time to contact the hospital again. I have contacted them both through USPS and e-mail regarding my accounts and they refuse to respond.

Does anybody know if they are obligated to pay the 65% assistance I am eligible for? I know some hospital's I've been in have signs posted saying that they are legally obligated to provide assistance to those within certain financial guidelines. Are they just trying to bully me out of requesting a refund? Do I have any legal leg to stand on while fighting with the collection agency/hospital?

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Here is a letter you can send out to the CA:

Your Name

123 Your Street Address

Your City, ST 01234

ABC Collections

123 NotOnYourLife Ave

Chicago, IL

Date: _________ CMRR#____________

Re: Acct # XXXX-XXXX-XXXX-XXXX

To Whom It May Concern:

This letter is being sent to you in response to your attached letter.

If you have nothing in writing use the phrase "recent communication, if you have had NO communication other than the entry on your report, use this:

"This letter is being sent to you in response to your recent fraudulent verification of an unknown medical account on my (name of CRA) report"

This is not a refusal to pay, but a notice that your claim is disputed.

Under the Fair Debt Collections Practices Act (FDCPA), I have the right to request validation of the debt you say I owe you. I am requesting proof that I am indeed the party you are asking to pay this debt, and there is some contractual obligation which is binding on me to pay this debt.

Please attach copies of:

Agreement with your client that grants you the authority to collect on this alleged debt,or proof of acquisition by purchase or assignment.

Agreement that bears the signature of the alleged debtor wherein he or she agreed to pay the creditor and as this is a medical account a copy of any HIPAA authorization.

Please also be advised that this letter is not only a formal dispute, but a request that you cease and desist any and all collection activities, including reporting of; or verifying of this account on my credit reports.

Your receipt of this letter will be considered as having granted consent to the taping of any and all telephone calls to me at my home or business by you or your agents or assigns.

I require compliance with the terms and conditions of this letter within 30 days. or a complete withdrawal, in writing, of any claim.

In the event of noncompliance, I reserve the right to file charges and/or complaints with appropriate County, State & Federal authorities ,the BBB and State Bar associations for violations of the FDCPA, FCRA, and Federal and State statutes on fraudulent extortion and illegal collection activities on any account that may be time-barred as well as being subject to the HIPAA and (name of your State) medical privacy rules.

I also hereby reserve my right to take private civil action against you to recover damages.

Sincerely,

Your Name(PRINT OR TYPE DO NOT SIGN)

Not only does this request validation from the CA it also includes a cease & desist to them too.

I have used this on many medical accounts and works well.

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you also need to add

as this is a medical account a copy of any signed HIPPA forms

and a copy of your business associates contract with ( name of dr/hospital) per HIPPA regulations

Business Associate Contract. When a covered entity uses a contractor or other non-workforce member to perform "business associate" services or activities, the Rule requires that the covered entity include certain protections for the information in a business associate agreement (in certain circumstances governmental entities may use alternative means to achieve the same protections).

In the business associate contract, a covered entity must impose specified written safeguards on the individually identifiable health information used or disclosed by its business associates.

Moreover, a covered entity may not contractually authorize its business associate to make any use or disclosure of protected health information that would violate the Rule. Covered entities that had an existing written contract or agreement with business associates prior to October 15, 2002, which was not renewed or modified prior to April 14, 2003, were permitted to continue to operate under that contract until they renewed the contract or April 14, 2004, whichever was first. See additional guidance on Business Associates and sample business associate contract language.

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An outstanding medical debt is a "debt" under 15 USC 1692a(5). Since there is no express exceptions under the FDCPA for debt incurred for the purposes of medical treatment, why do some folks continue to assume that there is some different threshold of responsibility placed upon the debt collector?

The collection agency's duties with respect its conduct, or to what it is required to provide under the FDCPA, is no different for medical debt as for any other.

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An outstanding medical debt is a "debt" under 15 USC 1692a(5). Since there is no express exceptions under the FDCPA for debt incurred for the purposes of medical treatment, why do some folks continue to assume that there is some different threshold of responsibility placed upon the debt collector?

The collection agency's duties with respect its conduct, or to what it is required to provide under the FDCPA, is no different for medical debt as for any other.

your correct a medical debt is no different,

except, there has to be a business accociates contract in place for a CA to have your "personal" information,( such as detailed billing statements that decribe procedures) and many states ,washington has a one thousand dollar fine" ( can be trebled) have something that does protect your privacy, I would very strongly suggest one contact thier nearest health and human resource office, or Civil rights dept, it is Not a FDCPA Violation, but it IS a violation never the less, Check your states Privacy rules/constituion

I personally have such a case pending against a Dr who did Provided a CA my PHI, and Detailed Billing statements , and the CA did Not have the BA contract, could be used as a "defence" as CA has no contractual rights to the information.( I spoke with my Civil rights Dept this morning,) seems the ATTY must also have a BA contract in place..

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I wanted to add, I am sure this is an agency that was assigned to collect the debt, as they still provide the hospital's web address for me to make payment, and the address to make payment is actually hospitals name and PO Box that appear on all statements.

I'm just seriously POed at this point because I think they're trying to collect this debt because I have contacted them repeatedly regarding the more recent charges that they were supposed to provide a refund of.

Also, according to the collection notice, they are trying to collect on three accounts. According to my records, two of the three accounts were paid in full in 2007. The collectors have been calling my cell phone three times a day since I received the notice, which is within their right, I guess. I just need to find my old checkbook so I can find copies of the checks that were sent as payment.

Mostly, I want to know if the hospital has any legal obligation to pay the financial assistance I was eligible for even though I put the balance due on my credit card.

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buckeyechick1219,

I can't help you, but I will ask you a favor.

I see your from Ohio and Ohio has at least one terrible law for consumers.

The 15 year SOL.

In order for this to change , all consumers in Ohio need to band together.

Write your Congressman. Go here: https://writerep.house.gov/writerep/welcome.shtml

Raise hell about the 15 year SOL.

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I wanted to add, I am sure this is an agency that was assigned to collect the debt, as they still provide the hospital's web address for me to make payment, and the address to make payment is actually hospitals name and PO Box that appear on all statements.

I'm just seriously POed at this point because I think they're trying to collect this debt because I have contacted them repeatedly regarding the more recent charges that they were supposed to provide a refund of.

Also, according to the collection notice, they are trying to collect on three accounts. According to my records, two of the three accounts were paid in full in 2007. The collectors have been calling my cell phone three times a day since I received the notice, which is within their right, I guess. I just need to find my old checkbook so I can find copies of the checks that were sent as payment.

Mostly, I want to know if the hospital has any legal obligation to pay the financial assistance I was eligible for even though I put the balance due on my credit card.

** If the hospital has a charity program No they do not have to give it to you

they can deny for what ever reason they choose, its chartiy and Not a forced program on thier part.

second many many larger Hospitals have thier own 'in house" collections and dont usually send out past due accounts for a year or more, for the calls,

Be polite and tell them give me XX days to find my information on this matter,then i will contact you on X day. . when you find your payment , sit down and mark each one off on the billing statement, then photocopy them in order and send to the hospital/ca CMRRR

& if you feel your being "harrassed" call the hospital director , explain your trying to work with "thier' collections dept, but they are not giving you anytime to collect your proof of payments you need at least (x) days to get them from your bank..and that you where under the impression that thier 'social services dept" was going to help you with this X account.can they find out WHY you where denied? Can you still apply for the assistance?

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I contacted them last week regarding the most recent accounts that they owe me a refund on and they're supposedly having a supervisor research it and contact me back by Wednesday. When he/she calls, I will ask if I'm still able to (re)apply for the assistance for the accounts from two years ago. I started collecting statements and discovered that they did not apply the financial assistance for one or two of the accounts, but processed it for the others. The financial information was the same, so I'm not sure what the problem was.

I will try to keep this updated for any others that may be having the same problem.

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  • 3 weeks later...

Just an update on this situation.

The hospital did not call me back by the following Wednesday, as they had stated, so I followed up with an e-mail to them on Thursday (per their instructions), and again they didn't respond, so I sent another e-mail the following Thursday and they called and asked me for the name of the person who had told me I would be receiving a refund because they were pulling the calls. Wanting everything in writing, I sent the list of names of people I had talked to back to them in writing and requested that, if they decided not to issue me a refund, they send me copies of all recorded conversations regarding not only the current accounts, but also the ones from 2006 as well. They indicated that there were "a lot of tapes" which if there are...I'd like to know who they were talking to because I avoided their calls like the plague until I finally spoke to somebody one time and made payment arrangements.

In the meantime, I sent a DV to the collection agency that is attempting to collect on bills from 2006 and, although the letter they sent me said to send all questions to the CA, I also sent a letter to the HCAP/Charity Assistance team with a copy of the original application that I sent them in 2007 that they never replied to asking why the assistance was denied, why I was never notified, and why there were never any attempts made by the hospital to collect the balance due until now, two years later.

I also found a letter from PCB, who was originally trying to collect these accounts in 2007, that said the accounts were closed. Again, the hospital never tried to collect these accounts after I received notice that PCB had closed the account.

Basically, right now I'm sitting and waiting for a response from the three different agencies, and then I'll see where to go from there. I have a feeling the phone call with the promise of a refund is going to magically disappear, just because I feel like I'm seriously being yanked around here. My husband wants to see if there are any violations that we can go after the hospital if this doesn't get resolved, but 1) it's the only hospital my OB/GYN delivers at and I do plan to have more kids in the future, and 2) his father works for the hospital system and I don't know that they would look too favorably on a lawsuit, even if there were violations made.

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Just an update on this situation.

The hospital did not call me back by the following Wednesday, as they had stated, so I followed up with an e-mail to them on Thursday (per their instructions), and again they didn't respond, so I sent another e-mail the following Thursday and they called and asked me for the name of the person who had told me I would be receiving a refund because they were pulling the calls. Wanting everything in writing, I sent the list of names of people I had talked to back to them in writing and requested that, if they decided not to issue me a refund, they send me copies of all recorded conversations regarding not only the current accounts, but also the ones from 2006 as well. They indicated that there were "a lot of tapes" which if there are...I'd like to know who they were talking to because I avoided their calls like the plague until I finally spoke to somebody one time and made payment arrangements.

In the meantime, I sent a DV to the collection agency that is attempting to collect on bills from 2006 and, although the letter they sent me said to send all questions to the CA, I also sent a letter to the HCAP/Charity Assistance team with a copy of the original application that I sent them in 2007 that they never replied to asking why the assistance was denied, why I was never notified, and why there were never any attempts made by the hospital to collect the balance due until now, two years later.

I also found a letter from PCB, who was originally trying to collect these accounts in 2007, that said the accounts were closed. Again, the hospital never tried to collect these accounts after I received notice that PCB had closed the account.

Basically, right now I'm sitting and waiting for a response from the three different agencies, and then I'll see where to go from there. I have a feeling the phone call with the promise of a refund is going to magically disappear, just because I feel like I'm seriously being yanked around here. My husband wants to see if there are any violations that we can go after the hospital if this doesn't get resolved, but 1) it's the only hospital my OB/GYN delivers at and I do plan to have more kids in the future, and 2) his father works for the hospital system and I don't know that they would look too favorably on a lawsuit, even if there were violations made.

read this

http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/businessassociates.pdf

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