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medical collection for bill I do not owe


cdmosaic
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Any thoughts on how to deal with this medical collection? I have been sent to collections for 4 ER’s visits to the same hospital over a one year period. I paid my portion per my insurance of the $100 co-pay per visit. However, the hospital refuses to remove the collection or update their records and for 2 of the ER admissions they failed to submit a claim to the insurance and are billing me for the total amount.

I have written the hospital, their revenue collection department, their collection agency and my insurance provider for more than one year now. So far I am in limbo and the collections remain. Because they didn’t submit claims on 2 of them my insurance can’t help me with those and the hospital ignores my correspondence.

I do not owe these bills, any thoughts on how I can get them removed?

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Obviously dispute the debts with the CA, and the minute the TL appears on your CRA without the dispute notation you file suit against the CA for the FDCPA violation of misrepresenting the character of the debt and the FCRA violation of failing to report a known disputed claim as disputed. I am sure when the CA gets sued they will be in contact with the hospital.

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Actually, if you did enter the ER those 4 times, You are the one that is responsible for payment. The hospital is under no legal obligation to file your insurance. Although most doctors offices and hospitals will file your insurance complimentary, unless it is Medicare or Medicaid, they are not legally required to do so, that is the policyholders responsibility. It is your insurance, not the hospitals so if for some reason the hospital has not filed your insurance or they did not follow up when payment was not sent to them all you need to do is to do it yourself.

Edited by docniss
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Docniss,

For what it is worth my insurance provider informed me that the network provider has an obligation to timely file claims and if they fail to do so, the claim will be denied. Even if I file it on their behalf (which I have). They further stated that I am not financial liable for the providers failure to adhere to the contract with the insurance provider.

Unfortunately, even for the 2 claims they did file, they are still incorrectly billing me. So, I paid my co-pay, they were reimbursed by insurance and they still have outstanding collection. I believe I will dispute with CRA, (already sent in dispute to CA) and take it from there.

As a side note - this same provider submitted 7 claims for procedures and service dates never perfomed. 5 of them were for 30 day periods each. In other words, 5-30 day hospital stays were I was never in the hospital. I have submitted those to my insurance special investigations unit for fraud. I think I will have to sue them and I do have all the proof. Thanks!

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