Sorry in advance if this question has already been answered, I'm still becoming familiar with the site. In 3/03, I had a hospital stay that set me back with a bill for $1400. There was some miscommunication between the hospital and insurance company for a year or so, and it wasn't paid for some time. I received notice from ConsumerInfo.com that a new account was added to my credit report. I never paid the bill. Fast-Forward to 7/05: I checked my annual credit reports, and the CA was listed as PAID in 4/05. I'm not sure who paid it, but it wasn't me. This CA is the worst mark on my CRs, according to all I've read. Most of my reading has been Guerilla Guide to Credit Repair ('94) and Your Credit Score ('05). According to Liz Pulliam Weston, the best approach to fix this particular mark is to dispute it as not mine. Is there a better way to go about this? Is there a specific letter I should use, or should I just use the dispute page on the back of the CR? Note: Disputing as not mine seems like a good idea, because the original creditor is out of state.
Have you checked with your insurance to determine if it was paid by them, and when, and whether they paid the original hospital? Also what was the reason for their delay in payment? Improperly submitted claim?
The claim was submitted improperly, and I have not spoken to my (former) insurance company. I am not sure if the CA was paid or the OC. I will find out as soon as I find the customer service number. I already called the CA, and they were unable to tell me.
I haven't found the customer service number yet. Is it of utmost importance to know whether the debt was paid by the insurance company? Thanks.
Regardless of what your CR says, the account may, or may not actually be paid, and the amount paid, or due from you depends on insurance. Get that from your insurance company, as an EOB. In addition, the account may have gone to the CA due to problems or errors with the claim as submitted to the insurance company. If this was finally straightened out, and the provider paid, then the account should also be retracted from the CA, and removed from the CR. In other words, if once the provider and the insurer met their contractual obligations to eachother, you owed nothing, or paid promptly on receiving a timely bill for the remaining balance, for what legitimate reason should the TL be on your CR for errors made by others? The CA was sent the account, attempted to collect an amount not due, and posted the TL, in error, so that is the ethical, if not legal basis for demanding that it be removed.
Oh, I forgot to add that the only address the CA might have had was my apartment address that I moved from around the time the OC was contacting me. The account was paid, I spoke to the CA in attempts to find who paid the bill. They said all they knew was that it was paid.
Contact the hospital. If they were paid, or told the CA they were paid, they should know who paid them. If they had to resubmit the insurance claim to get paid, they would also know that. If the hospital was paid directly, and if they were paid by insurance, they would have been paid directly, and not thru the CA, then the CA is only posting the TL at the direction of the hospital, so that is who you need to pressure to get it removed. Your basis for removal would be that the hospital submitted the claim in error, that they were then paid after correcting their error, and that they should not be damaging your credit due to their claim submission errors.
Also contact the insurance company, as a check on the hospital. You should get an EOB, showing what the insurance company paid, and any co-pay owed by you after that payment, along with the date the insurance processed the claim, and references tying the EOB to the hospital bill and services. Some insurance companies don't send EOBs unless requested if no co-pay is due, which may cause problems like yours, but you can always ask for a copy.
Update: I called the hospital today, and according to their records, they resubmitted the claim in 2/04 (service was in 3/03). They said they were paid on 3/4/04 or 3/27/04 (the lady on the other end was kind of an idiot) but that I still owe $392. I contacted my insurance carrier at the time, and they said the claim was paid on 3/18/04. They're going to send me an EOB right away, and I forgot to ask for them to fax it to me.
Did they send you a bill for what they claim is remaining due, after they were paid by insurance? Did they have your current address at the time to send that bill to?
Where did the "paid in 04/05" come from? Start with the EOB. If it says a co-pay or additional amount is due, make sure the hospital correctly submitted the claim as in-network if it was in fact in-network.
They sent me no bill. I will check to see if they have the correct address. Looking at the copy they sent me of the claim form (signed 5/10/04), they show the correct address, except the ZIP is one digit off. It could have been typed wrong, or they could actually list the incorrect ZIP in their records. As for the 04/05, that's according to EQ. EQ CR: "Balance as of 04/2005 - $0 ; Last Payment Date 04/20/2005" TU CR: "Date Paid: 04/2005" EX CR: "$1430 past due as of Oct 2004." I believe the claim was out-of-network.
OK I finally got everything sorted out between the insurance carrier and the clinic. Turns out I owe the clinic $392. I was thinking I should write a letter requesting removal of the CA TL if I pay the bill. Any suggestions?
Presumably insurance now paid a substantial amount, and there may have also been an "adjustment" further decreasing what you owe. What does your new EOB show? How much did insurance pay? How much was the bill reduced due to an insurance "adjustment"? What part of the problem was due to how the claim was submitted, and how much was caused by problems originating on the insurance side? On having part or all of the claim rejected, did the provider promptly send you a bill, or just sit on it before sending it to collection? In other words, during the period of "miscommunication" between the hospital and the insurance company, did anyone contact you? Ask the medical provider for a corrected bill. Pay that timely to the provider. Then request that they remove, since their prior bill that was sent to collection was in error. Do everything in writing, with any contact by phone followed up by letter, CRRR. What you want to force to happen is that the provider does the right thing: accepts payment on a corrected bill, and removes any CA TL. Insurance mix-ups happen all the time, are fixed all the time, even after being sent to collection. Hospitals also frequently bill to addresses with errors. My own experience shows an error rate of about 15%, and half of the addresses on my CRs are the result of medical provider garbling. Were any of the doctors involved in treatment also your on-going, or primary care, doctors? Hospitals are providing service to both you and your doctor, and part of that service is accurate billing, including re-billing after claims and payments are processed. When you as a patient choose a doctor, you also expect him as a professional to be working with other providers who provide quality services, whether medical or billing. You depend on his experience and contacts in the medical community to assist you in choosing those other providers. If the cost of his care is that your finances will be trashed, you will not be a happy customer. He has an interest in the hospital handling its billing in a responsible and professional manner, too. It is bad business to trash your customers.
Today I got my first chance to talk with the accounts mgr at the clinic. First I asked if the late charge of about $60 could be removed, since the clinic made an error in submission. She said that once it goes into collections, the finance charges could not be dropped. She then proceeded to tell me that it wasn't the clinic's responsibility to submit the claim; it was my responsibility because they faxed me the claim on two different occasions. When I received the claims, I sent them to a person at the HMO. I gave the number of the HMO to the clinic and vice versa. Twice. When I asked what to do about the TL on my CRs, she said that nothing could be done about it until I paid, at which point my CRs would list the collection as PAID. Apparently she doesn't know that this stuff can be removed. ontrack, thanks for all your help, and for anything more you have to say. I put in a call to my law firm, because this seems a bit complex to me. I expect a call back later today. Hopefully they can write the necessary letters and get all this squared away.
Also contact your insurance company to put pressure on them. If the clinic is in-network, it is their responsibility to submit a claim, and a correct one at that. Even if they are out of network, and they submit a claim that is erroneous, it is their job to submit a corrected one. They routinely deal with insurance companies, and are responsible for having billing departments trained in submitting correct bills. All the medical billing codes are standardized, known to their employees as well as the insurance companies, and patients cannot be expected to be experts in this. Your attorney may have to remind them that you are not responsible for their erroneous, and possibly frauduent, billing acts. If the insurance carrier was not even in the picture, and they sent YOU an erroneous bill, would you be stuck with it just because they had sent it to collection? They can choose to waive any charge they added at any point, whether they sent it to collection, or not. If they made the mistake, they are responsible for correcting it. You can also send a letter to the doctor who provided the medical services. Tell him that although his medical services were good, his billing department has screwed up the insurance billing, and now that you have finally gotten them to fix it, they are trying to collect additional fees resulting from their own errors. You are very disatisfied with their unethical conduct.
When I received a call back from a lawyer, he said that paying the claim is my responsibility, whether or not it was filed with the insurance company. After faxing my CRs to him, he called me back and asked for clarification of what I wanted. He thought that I wanted my EX file to list the CA as PAID, like the EQ and TU. I clarified that I needed the TL removed completely from the CRs. Upon hearing that, he paused; he seemed a bit confused, like he had never heard of that before. He then muttered out, "Well, I guess I'll just send a letter to the credit reporting agencies." What should I suggest to him? I suppose I could email this link to him, and see what he thinks.
