During the birth of our second child, we had some insurance issues, and as such, had owed a few hundred dollars to the doctor. I've been dealing with the insurance company regarding it for a while, but during that time, the account slipped into collections. My wife has continued to see this obgyn practice and has since had our third child. No insurance issues have happened since then, everything has been paid by insurance without an issue. However, this outstanding about is still owed, and I had begun paying $100 each time my wife visited the doctor. I contacted their billing office in May and got the total amount due, which was around $700 and have been paying the $100 towards that. This past Friday, I wrote them a check for the remaining balance of $164 which would pay it in full. The refused the payment and said we now owe $400. I called their billing company and the lady on the phone said that on her screen she has a note from May showing the amount due of $700 and the check I wrote would pay in full. So, the practice shows a different amount than the billing department and collections. And the practice refused to accept the check. My wife then asked for a billing statement, which they refused to provide. In looking at the HIPPA laws, it looks to me that it's your right to request a billing statement and it cannot be refused. I've left a voicemail every day last week with their office manager, sent her a fax, and a certified return-receipt letter. I have not received any calls back.
How frustrating...it sounds to me like one of the main problems is that your account is still in collections yet you've been making payments directly to the medical provider's office. It's quite common for there to be discrepancies between the records of the medical provider and the collection agency, which is why you want to deal exclusively with one or the other. Is this an in-house CA, or is it being handled by a outside collection agency? Also, do you have a copy of invoice with the total amount due from May?
It's an outside collections agency as well as an outside billing agency. The billing agency told me that they see notes in their system from May showing the correct amount due. When the billing records were requested, we were denied a copy of them.
This is how I would personally respond. (Hint DSDA is a general acronym that I utilize - the D's stand for Dip and Dumb respectively, so most people can figure out the rest of the acronym from that.) Dr DSDA & DSDA Billing & Collections: Please be advised that I am in receipt of the letter wrote by your office on xx/xx/xxxx, where your offices refused the check in the amount of $164 to completely pay for the account in question. This is the amount that I was repeatedly advised would be the amount to completely pay for the account in question following my payments of date xx/xx/xxxx in the amount of $xxx, and xx/xx/xxxx in the amount of $xxx. Said payment is once again enclosed in this envelope, and your company is hereby once again advised that said payment of $164 completely pays-in-full the account in question, following the aforementioned payments. Please be advised that it is generally not my practice to facilitate the communications between the Doctor's office, and the company whom the Doctor chooses to contract to utilize for their billing and collection services, since it is in fact the Doctor's choice of whom to utilize for said services, however due to the history that we have together, I have chosen to be generous, and make an exception in this case. Should your records indicate a different amount due than DSDA Billing & Collections records are showing to completely resolve this account, I hereby am demanding conclusive documentation of said amounts in accordance with the Fair Debts Collection Practices Act, and the Health Insurance Portability and Accountability Act. Please be advised that should your practice choose to refuse to accept this payment for the complete balance of the account, any future communications from DSDA Billing & Collections in regard to this matter will be treated as inconvenient communications, continued collection activity, and harassment under the Fair Debts Collection Practices Act, and a case will automatically be filed in the United States District Court for the () District of (State) under the Fair Debts Collection Practices Act. (Googling City, State Federal Court should give you the district courthouse for your jurisdiction.)
Thanks jam237. So you suggest this be sent to the billing company (the middleman), not directly to the main Dr in charge of the practice?
Thanks again. Letter was sent CMRRR. Got the return receipt back a week ago and they still haven't deposited the check. Should I just let it be, or is there any follow up I should do?
I would give them a bit more time than a week to respond. You might try waiting 2 weeks for a response before following up again.
Just wanted to post a follow-up to this that I received a letter yesterday from the main partner at the doctor's office (the one I sent the CMRRR to) that the check is accepted and the account balance is now $0. They put in there something in the letter basically trying to say it was all my fault but they will accept my check as final balance. I think they just were trying to save face since they knew I pretty much had them by the balls if I took them to court for FDCPA and HIPPA violations (I added to the letter you suggested and actually specified the statutes which they violated). Thanks again! -Dave
I'm happy to see that you found resolve with this issue, but I work in a medical clinic where our billing/collections are done by a third party & this is a VERY common scene. As I always advise any potential client when scheduling, speak with member services/customer service & know your expectation. If you give the tax ID # or NPI # for the provider, they should confirm participation/affected benefits. After reading your situation, I wonder if your account was ever "adjusted to the contracted rate" or if they retained your account charges at the "customary rate". Your EOB is ALWAYS your friend & I keep mine faithfully stored for my access should anything arise from it. One piece of advice that I must add is to write on your check EXACTLY what you're paying...it's your friend indeed when you must present your case. Another piece of advice is to N-E-V-E-R pay in cash (even if they write you a receipt) because these payments can "disappear"..(not the 5 finger discount way, but if you have a dispute to what you're paying toward - that payment can get applied ANYWHERE there is a balance, new or old). Most practices will apply the balance to the oldest first & then newest because they don't want it to roll to collections to pay outside AGAIN for what they were paying the biller a percentage). Good luck in the future... SisterGirl
