CA and hospital bills - validation?

Discussion in 'Credit Talk' started by holis, Aug 18, 2003.

  1. holis

    holis Well-Known Member

    I sent 1st validation letters to a CA for some old hospital bills - they sent back
    1. credit disclosure statement (provide w/ validation letter)
    2.Itemized statements from hospital -has my info on it (name, address, phone #, employer, ins company, policy number, ins. payments to each account.

    Is this adequate validation from them or do I proceed to the next step.
  2. holis

    holis Well-Known Member

    bumping to add -
    There is a paper that each hospital makes you sign that states that if the insurance company doesn't pay all charges you are responsible for whatever the balance is. Would a copy of that be needed? - i didnt get any of those w/ paperwork
  3. holis

    holis Well-Known Member

    The particular outfit (Attention LLC) has called me two times during my validation 30 days.

    Has anyone worked with them ?

    THe validation they sent is incomplete and shows nothing with my signature, just some screen prints from the company computer.

    DO I wait for the 30 days to expire or followup now, since they sent invalid validation?

  4. holis

    holis Well-Known Member


    Any input would be appreciated :)

  5. keepmine

    keepmine Well-Known Member

    Your post is confusing. You first say you received an itemized bill from the hospital. Later, you say it's a computer pintout from the company {I assime the CA]. What's the real story. It makes a difference.
  6. holis

    holis Well-Known Member

    it was a printout from the CA - sorry bought the confusion.
  7. keepmine

    keepmine Well-Known Member

  8. ms6073

    ms6073 Well-Known Member

    Did you visit the health care provider and expect that aside from applicable co-pays, deductible, or other non-covered/out-of-pocket expenses that the bills would be be covered by insurance? The hospitals statement is only partially correct - you are responsible for any charges that are not covered by insurance. On the other hand, you should not be held responsible for bills not paid by the insurance company if the hospital was negligent in its responsibility to file timely and accurate claims with the insurance company! If the disputed amounts are the result of you not paying applicable patient expenses such as patient co-pay, deductible, or other out-of-pocket expenses then you can stop reading as the rest will not help apply to your situation.

    First, you will need to contact the insurnace company and review the claims history for the period (year) in which these hospital bills were incurred. You are specifically checking to see if all claims for service were filed and subsequently paid by the insurance company. My guess is that the hospital or its billing department/service may have either filed inaccurate claims or simply failed to file the claims for your visit in a timely basis (usually within 90-days). You may find that several claims were filed and denied/returned or you may even find that no claim has ever been submitted. Why is this relevant, because despite the hospitals disclaimor, under federal and most states medical insurance reform acts/laws, claims that are not accurate or submitted to the insurance provider in a timely basis becomes the responsibility of the health care provider and not the patient!

    If this is the case, then more than likely you will need to involve your states Attorney General - most have websites that allow for filing formal complaints online - as well as consulting a lawyer so that the a letter to the hospital can be drafted that reminds the hospital of the applicable laws that the hospital may be violating in your state as well as to demand that due to the hospitals failure to file accurate/timely claims that they are required to "write off" the debt and immediately recall any and all related collection accounts! You should also continue to pursue the "normal" flow of validation with the CA - I would suggest that you counter their attempt at validation with a demand that the CA produce a claims history documenting that the hospital filed the associated claims with your insurance company. This should keep them busy until such time as you are able to get relief from the Hospital since this is actually the root of the dispute!

  9. holis

    holis Well-Known Member

    I also sent the creditor disclosure statement that the partially filled out and did not sign or date.

    Thanks for the assistance. Ill send another validation letter stating that they did not complete the validation and include the Wollman letter

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