Can I take legal recourse if a CA never contacted me?

[Rosiemoo]

I apologize if this question is similar to one asked before. I searched the forums but could not locate a question similar enough to mine to be of any help.

While checking my credit report I noticed a delinquent collection. Through a little bit of research I discovered it was for a chest x-ray I had in spring of 2009. My credit report indicates that the account went delinquent in Oct '09 and was turned over to a CA in Jan '10, with that account then going delinquent with the CA in April '10. In the 18 months since my x-ray I have never received any communication from the CA or the OC. So, what do I do next? Do I contact the OC or the CA? Is it illegal for them to report the account to the credit bureau without contacting me about it? I am willing to pay the expense since it is actually rather small, but I'm miffed that the information is on my report without me ever knowing about it. Thanks in advance. Oh! Nearly forgot, this occurred in Texas. I'm a recent transplant to Colorado.

[Guest usctrojanalum]

IIs it illegal for them to report the account to the credit bureau without contacting me about it?

No, it is not. Dispute it with the CRA's first off. Call up CA or OC and tell them you will pay it off in exchange for having it removed from your CR.

[Rosiemoo]

But I thought under the FACT act financial institution creditors are required to send notice that negative information may be posted to your credit report. All three credit agencies have this debit listed as a negative.

[retmar]

It is true FACTA requires they notify in writing that they may or will report the negative info. BUT, I see a strong possibility why you were not notified.

Your last sentence says you are a recent transplant to Colorado. Here are some questions.

1. Until you left for CO, did you reside at the same address? If yes, and you filed a COA upon leaving TX, keep your postcard sent to you by USPS acknowledging your move. If you didn't file a COA, it will be hard to challenge them on not notifying you. Also note last of #2.

2. If you moved while still in TX, and did not file a COA, that is a problem. By this, all they must do is to send the letter to your last known to be safe.

Here is the important stuff. Read carefully.

1. Was a health insurance in effect at the time of service? If yes, what did the EOB (Explanation of Benefits) say was your responsibility? This would be your co-pay or cost share. All EOB's show what is due from you. You are not liable for any other amount not shown on the EOB as your responsibility.

2. Was claim filed with your insurance carrier within the time frame allowed? If yes, you would again refer to the EOB. If no, and you gave them all info up front, they must write off and not bill you. BUT, there are times when the carrier will waive and ask the provider to refile bill and get paid.

3. If claim was denied, why was it denied? For example, if they denied it as deductible not met, you would be liable for only the allowed amount, not the billed amount. Too many times, billing offices try and cause payment for the billed amount, knowing they are not allowed to do so.

4. Was treatment and amount considered "Mutually Exclusive"? If so, the provider must write off and not bill the patient.

5. If claim was denied as more information was necessary, such, as have info another policy is in effect, it is the responsibility of the provider, not the patient, to obtain the necessary info, and refile. If the provider fails, they must write off and not bill the patient.

6. If no insurance is involved, they can bill you for the whole amount.

Therefore, if an insurance is involved, your best avenue of approach now would be to call them. They can produce a copy of the EOB and send to you. At the same time, you would ask them about providers who agree to accept assignment as to if they are allowed to assign to collectors. Some carriers do not allow it, not many, but, some. Of course, you would have them explain to you what is on the EOB, so you can note it until you receive it. What you want to know is if the amount they claim is the correct amount, etc. And, lastly, many carriers have a special department to assist you in this, so, ask if they do.

And, yes, if the amount is that small, and you feel right in paying, then, do so. Here you want to respond to them like this. Send a very polite letter to the OC that you just found the TL on your CR. Having no knowledge of alleged claim as you were never notified by them or their assignee, you wish to resolve this by remitting payment, if they will have the TL deleted. Tell them you moved, and, somehow, in the move, even with your COA being filed, you now find you did not receive all of your forwarded mail. Blah, blah. You get the drift. Some have had good luck with this. If they don't respond, then, do same with the CA. Understand, that if they try and tell you they cannot delete, make it clear they can. as the statute only says that "If they report, it must be true".

[Rosiemoo]

Thank you for your reply Retmar. I actually called the OC earlier today since I did not remember receiving a chest x-ray at the time they specified. I recalled having one in spring of '09 but they claim service was rendered in Oct '09. I called the referring doctor (whom is a doctor I have seen) to verify what day they referred me for an x-ray. I'm waiting for them to call back.

When I mentioned to the OC that I never received a notification of the debt they read me the address they had on file. It was for an apartment that I had not lived at for 4 years and there is no way they could have gotten this address from me. The lady mentioned it might have come from the referring doctor but that should be false since his office had my updated address. I'm vaguely wondering if someone used my identity to get an x-ray, hence my calling the referring doctor.

To answer your questions:

1. I resided at the same address for over 3 years prior to my move. Yes, I filled out a COA every time I moved, including this last time.

2. Always filled out a COA. And since I didn't move from the time they say service was rendered until it was reported to the CRA this should not be a problem.

For the insurance questions, it's a bit complicated. At the time that I remember having an x-ray I was on my parent's insurance since I was a full-time college student. For the date that the OC claims service was rendered I was not on any insurance. My parent's insurance was odd in what it would cover. I have kidney problems that require monthly urine tests and every month the insurance would cover a different amount for the exact same test. When questioned about it they spouted legal mumbo jumbo at my father and he let it go. At few months after my x-ray I was dropped from the insurance and I figured with how long it usually takes medical places to file that I would shortly be responsible for the whole bill and began saving. When I never received anything from the company I, naively, assumed the insurance covered everything and let it go.

If it was in-fact myself that received the x-ray than the money I owe is simply the co-pay and I will pay it. Firstly I need to be sure that identity theft didn't occur since the date is so different from when I remember receiving the x-ray. If it was my x-ray (in which case I would qualify for worst memory ever) then I am going to send the letter you mentioned. It would be awful if I paid and the TL stayed on my credit.

Thank you to usctrojanalum for your answer, also.

Edited September 14, 2010 by Rosiemoo

[retmar]

Regarding the address, if this be true, and very possible it is, the most common cause is when you give them your correct address, they never enter it into the system. This is why when I have had to do this, most recent was a new phone number, I stand there and make sure they do enter it. At the same time, I've learned that some when changing info are required to hit a "save" button to complete, but, don't, and guess what. The comment from the provider as to they received it from the other Doctor tells me the problem lies with the first Doctor's office, or, they are trying to avoid blame. This can be remedied by contacting the first and see what they have in their files. Too many times it is found the problem lies at the counter as the person checking you in or out pays little attention to details. Or, the referring Doctor's office having sent the info over, which is standard, may have not "updated" your file properly.

As I mentioned above, this past week we had to have a new element installed in our dishwasher, from a recall with Maytag. Being on file with Maytag, when I called to set appointment, I asked them what phone number they had, as time had passed. They had my old, which I gave them new. While waiting for the repairman to call to tell us when he would arrive, our doorbell rang and here he was. Guess what? He tried to call our old number. They never changed it.

Though true that many providers do not bill promptly, your being removed from policy is not a problem, as if the treatment was performed while on the policy, they must pay. Yes, I've found where the processor of the claim ignores this and denies for that reason. All you would do here is to contact the carrier and show them their error.

Also, you are not naive. The majority of people pay no attention once they leave the Doctor's office, and only respond when notified a problems exists. Trust me, this is what brought me to this site back then, all due to medical bills. All EOB's were looked at and tossed. Statements were opened and tossed as we knew the claim had been billed. It wasn't until a collector notified us did we know a problem existed. From there it was a battle I won in the end, but, it was a long battle.

With what you have found out now, I would still contact the carrier for a copy of the EOB. This way you know everything, including if a name error was made. Was it your father? Mother? I would assure this office has knowledge that somewhere your change of address was not honored, as you definitely did provide your current info at a time prior to or during that treatment. Hold firm on that and do not allow anyone to tell you different. And, yes, upon receipt of the info as to date of service, make sure it all jives.

Make no further contact until you have the EOB and have found what is and isn't true. Then, you will respond accordingly. Again, you will want to prove the problem is on them, to assure the TL is deleted from your CR. Do not cave for any reason. Do not believe if they try and tell you that you are required to check to see if claim is properly paid. This is a pile of "stuff" used by many in the industry.

By this, once you have your ammo in hand, you will contact the OC in writing, blaming them for the problem, proof enclosed, and that upon your receipt they have asked their assignee to close and delete account, as you refuse to deal with their assignee, you will remit balance due. Assignee must send you a letter they have acknowledged this. Once you have a response, you will respond accordingly. If they refuse, let us know for another approach. Understand that you cannot be forced to enter into an agreement and/or contract with a third party collector, so, do not let them tell you you must.

Edited September 14, 2010 by retmar