Turned over to collections for medical bill - advice needed!

[Ringo1]

[QUOTE=yorkietalkjilly;3646861]He's likely still contracted as most providers won't refer out of network per the contract so whoever referred you for the tests agreed to refer in network unless there are no network providers who can provide the service. Check with your former network and see if that provider was inn(in-network). Ancillary providers have contracts too oftentimes.

If it was out of network(oon), you still should not have to pay due to their error in billing. A nice letter to the provider stating that by not billing correctly and allowing payment to be made by your insurer, they have caused you harm and deprived you of the benefits your insurer would have paid but for their mistake. In that event, the harm is done to you and you did nothing wrong and should not have to financially cover their mistake. Send copies to your state Attorney General, Insurance Board, Department of Labor (if an employer self-insured plan). Let the world know by copy what they did to you and I'll bet they will stop pushing this. Ask for a letter forgiving this debt since it is owed solely due to the provider's error and through no fault of your own.[/QUOTE]

Ooh, I'm loving this wording! I can see a second letter going out next week containing all of this with the request for the letter forgiving the debt.

[kjcmsw]

make whatever payment you can reasonably afford, once they accept three payments of that amount, they have to continue accepting it.

[J_is_my_initial]

gonna make an enemy or a lot here but here goes:
I work for a call center for a company that supplies er physicians all over the country. So I talk to people about their er dr bills 5 days a week. I am wondering about something and just some thoughts about medical billing.,

Did you talk to the company before it went to collections? That is the time to ask for any review of possible mistakes in the billing. If insurance denies it for a coding error, the insurance needs to tell the medical group what they think wrong code is or we do not know. If the eob sent to us by the ins just says service denied or not covered then we have to send it to the pt. It is up to the pt to follow up with the ins. We can only bill it, can not make them pay.

Services were provided to the pt, it is the group's job to bill the ins with info provided. it is up the pt to make sure we have the correct info. If ins says not covered, it is between the ins and the pt.

If you ever suspect there is a coding error, ask for the coding to be reviewed. Med grps will do this. errors are made. but you have to ask while they still have the acct. If you get a bill do not assume that ins will take care of it. Call the first time you get a bill. We get calls every day from people who are mad their acct went to collections. We tell them the dates the bill went out to them(usually 4 times ). they say i thought ins was taking care of it. Call at the first bill.

If you need to ask your insurance to call the grp that is what you pay them for. If the bill has went to an outside collection you have to talk to them as the original biller no longer has the acct. Sometimes the ins makes mistakes too.

what code are they disputing? again it may have been coded correctly but the ins processed it wrong. When did you first talk to the provider about a possible problem with the billing?

Sorry everyone. I get so frustrated with people arguing with me about taking responsibility for the bills. Not saying this is the case here though. I even get cussed at when asking for some to provide the ins info.

[yorkietalkjilly]

To my way of thinking, the billing service/provider should do due diligence and check the denial EOB they got back for patient info/insurance errors in a timely fashion. Apparently they even failed to do that in a professional manner. So many providers won't "work" their denial EOB's and just try to pass the balance off to the patient. If the provider wanted their money, they should have done their due diligence at the time and checked all of that when the payment was denied.

[BabyGirl Rosie]

We had something similar happen to us from my DH's first marriage. They kept sending us bills 20 years later. I finally got sick of it and consulted a lawyer. Well, that did the trick. And it only cost me $50. Money well spent in my opinion. Haven't heard from them since and it is not on our credit. My lawyer said you would be surprised how many people just pay it. If you have a lawyer, you might give them a call and see what your rights are.

[Ringo1]

Originally Posted by J_is_my_initial

gonna make an enemy or a lot here but here goes:
I work for a call center for a company that supplies er physicians all over the country. So I talk to people about their er dr bills 5 days a week. I am wondering about something and just some thoughts about medical billing.,

Did you talk to the company before it went to collections? That is the time to ask for any review of possible mistakes in the billing. If insurance denies it for a coding error, the insurance needs to tell the medical group what they think wrong code is or we do not know. If the eob sent to us by the ins just says service denied or not covered then we have to send it to the pt. It is up to the pt to follow up with the ins. We can only bill it, can not make them pay.

Services were provided to the pt, it is the group's job to bill the ins with info provided. it is up the pt to make sure we have the correct info. If ins says not covered, it is between the ins and the pt.

If you ever suspect there is a coding error, ask for the coding to be reviewed. Med grps will do this. errors are made. but you have to ask while they still have the acct. If you get a bill do not assume that ins will take care of it. Call the first time you get a bill. We get calls every day from people who are mad their acct went to collections. We tell them the dates the bill went out to them(usually 4 times ). they say i thought ins was taking care of it. Call at the first bill.

If you need to ask your insurance to call the grp that is what you pay them for. If the bill has went to an outside collection you have to talk to them as the original biller no longer has the acct. Sometimes the ins makes mistakes too.

what code are they disputing? again it may have been coded correctly but the ins processed it wrong. When did you first talk to the provider about a possible problem with the billing?

Sorry everyone. I get so frustrated with people arguing with me about taking responsibility for the bills. Not saying this is the case here though. I even get cussed at when asking for some to provide the ins info.

Yes, I did talk with both when all this started (years ago) and thought all this was settled long ago. Unfortunately, this was all over the telephone and I have nothing in writing from my initial calls to the insurance carrier. This time around, it will all be by mail.

I'm frustrated with both the Provider AND the insurance carrier. I paid thousands of dollars for insurance coverage and resent having to pay for a covered service because the Provider failed to bill correctly or the two are two lazy to communicate and it's just easier to bill me.

I just bought a new house last year - so my credit rating is good - and I'm not known for NOT paying my bills.

I understand your point; but I consider myself to be a reasonable person. I will argue the case to the best of my abilities; and while I work with attorneys every day - would probably not involve them in something this trivial. Ultimately, I only have so much time to devote to this provider OR my ex-insurance carrier and it could be cheaper for me in the long run - to pay the bill.

We'll see what response I receive and move forward from there.

Thank you for your insight from the 'other side of the desk' so to speak!