I have four collection accounts showing on my credit reports as "collection unpaid" after my investigation the accounts are not mine but for my minor daughter. I called collection agency Central Financial Control and informed them that my daughter has been continually covered under the same insurance since her birth in 1984. The collection agent told me that the insurance claim was filed and denied as my child having no coverage. I called employer SBC and it was confirmed that my child was covered on the date of services. The collection agent told me good luck and even if the insurance company does pay that they will update as "paid" and it will remain on my credit report. The collection agent insisted that I am the responsible parent where I NEVER admitted my child to the hospital. The hospital "clerk" named me responsible. I explained to the collection agent that I am not the responsible party and that her father has mantained insurance her entire life. The collection agent explained to me that I am her mother and under Texas Law I must pay the bill. I am lost... I can't clear my good name. I sent the collection agency the first page of my divorce decree and page 14 that stated my former husband must cover our girls medical etc.. and I sent a copy of the current (same) insurance coverage to this present date. The collection agency has NEVER contacted my former husband and only reported me as the dead beat. My youngest daughter has had over $1 MILL dollars paid out by the exact insurance company as she suffers with chronic actute asthma... yet my older daughter cannot get a SMALL claim paid of $144.00 and collection agency is treating me as dead beat sorry no good mother that doesn't pay medical bills. PLEASE.... Someone out there tel me what to do... I want to buy a house and this is KILLING ME!
The collection agency will always tell you that you are responsible, and that your only solution is to pay them. They have nothing to gain by telling you otherwise. You may be legally responsible for paying for any expenses necessary for your child's welfare, jointly with the child's father, yet there is still an issue of the insurance coverage which should have paid. If the claim was submitted with errors, it could have been bounced back to the hospital for correction. Often they don't correct, but just send it to collection. Get the original billing information from the hospital, and work with the insurance company to get the payment made. If the hospital had a contract with the insurer, (they were in-network), they might be required to submit all billing in a timely fashion, or the amount becomes uncollectible under their contract. If this is the case, they might be barred from collecting from you or the father. The CA will have none of this information, nor will they be interested in any resolution other than you paying with the least effort on their part.
Regardless of what the CA says, if the hospital still owns the account, it is in their interest to get paid, and they deal with insurance and billing problems all the time, even including calling an account back from a CA. If the hospital failed to follow up in correcting their insurance claim submission, or in notifying the responsible party to assist in that correction, that is your basis for demanding that they recall the account and remove the negative TL in exchange for insurance payment.
The other problem with paying a hospital bill directly, instead of thru insurance, is that the "list price" they are charging you is probably higher than what they would accept from the insurance company, whether they have a contract with the insurance company or not. You may end up paying 2 to 3 times what the insurance company would pay, and even if you later get reimbursed by the insurance company, it will be at their lower rate schedule.
You are absolutely correct. I had completely forgot that the insurance company has a contract with the SBC in-network providers. It clearly stipulates that the insured cannot be contacted for balances not paid or collection procedures. How the CA went around this is that the insurance company denied my daughter had coverage at the time services were rendered. I contacted the original creditor and know for a fact that they still have the records as the billing clerk discussed all the facts with me and kept putting me on hold to look over all the notes. The clerk ended the call telling me to get the insurance company to pay the claim. Now, there is no claim under the SBC contract as the hospital did not follow up and correct their mistakes from the beginning. I just want the negatives removed from all three credit reports. Do you feel I should send the hospital a very nice letter RRRR letter pointing out all the errors and demand they contact the CA to remove?
Ontrack is, well ... ONTRACK! lol You need to find out EXACTLY why the claim wasn't paid in the first place. It may involve tracking the process through until you see where the link in the chain of events got broken. I think what you'll find is that the hospital FAILED to either bill in the first place, or, once denied, failed to correct and bill again. In this case YOU do not have to pay, but they will try and get it from you. THEN ... it will be time to write this "nice" letter.
Put pressure on the insurance company to either pay the claim, or enforce their contract if the claim was not submitted timely and therefore not payable.
Do not assume the claim will not be paid, even if the hospital claims this. That is for the hospital and insurance company to work out. It's their contract.
The insurance was a group policy thru SBC CustomCare Prudential. Per the collector at Central Financial the insurance company denied the claims stating my daughter had no coverage at the time of services. On 01/01/01 SBC terminated insurance coverage with CustomCare and went with United Healthcare. Last week the SBC Benefits department verified that my daughter was covered on 08/13/00 and they opened a ticket for to me to resubmit the claim back to CustomCare and force them pay the claims. My guess is CustomCare is going to say it is too late to resubmit the claim for payment. The CA has told me if insurance pays they will only update as a paid collection. The hospital said they are sorry for never filing the claim again. FYI last month I called the hospital to get info about this unpaid bill and was asked if it was turned over to CA when I said yes the clerk told me they have no records. I called back last week and asked if I owed them any money. It was then I found out they do have all the records. I am really tired of the hospital and the CA.
As you are seeing, people say a lot of things whether they know or not. Start with the insurance paying the hospital. If you can get that to happen, or the hospital to decide they goofed and you are not responsible, then you can work on getting the account recalled from the CA and removed from your reports. Also you are seeing the CA has no interest in an equitable resolution consistent with each party's contractual obligations. If any client sends an account to them, they consider it valid, and take no responsibility for any errors, even their own. For them to do otherwise will cut them out of their commission. That is why you cannot deal with them. It will only damage you.
Follow up your contact with a letter to the hospital memorializing their admission of error (tactfully) and their agreement to resubmit. Are they "in-network" with your insurance?
Better that they are all "sorry" about messing up billing, than that they are sorry about a medical outcome. Billing errors can be fixed, and it only costs money. Since they are resubmitting, they know that they should have done that originally. SBC appears to have done the right thing, confirming that your child was in fact covered. The ball is now in the insurance company's court. If they accept and pay, fine. If they reject, your liability may hinge on whether hospital was negligent in filing timely, or who dropped the ball in claiming your child was not covered. Both parties can choose to do the right thing. Make clear in any communication with any of them that you expect this to be handled as it should have been originally.
Thank you ontrack for your help and excellent advise with collection agency abuse. I wrote CFC Collection Agency a letter explaining the hospital billing error. I received a nice letter from them stating that they are investigating the details outlined in my letter and they will respond to me in writing when their investigation is complete. They also stated that all collection activity has been suspended. I pointed out the hospital and providers were under contract and this account is uncollectible due to the hospital billing error. Thanks to you... I got em' I have a serious new problem with another collection agency. Please see my new post under Collection Agency Shysters.
If your insurance is refusing to pay due to the claim being submitted too late, or whatever reason they give, be sure to get their position in writing. In fact, with whoever you deal, get whatever they claim in writing. You want the medical provider and the insurance company butting heads, if that is what it takes. They are the ones who contracted with each other. You want to force each party to deal with the others, meeting their contractual obligations, whatever those are. If you just have verbal BS from everyone, they can keep "forgetting", as they continue attempting to collect from you.
