Hi, Newbie here. I read through the "best of" posts and searched for all posts related to my issue, but I have a couple questions still. I have a neg line on each of my 3 credit reports for a small medical bill that was not initially paid by insurance due to claim submission errors. After the account went into collection, the hosiptal finally sent a correct bill and it was paid by insurance. I want this line off my record. Should my first step be to A) write goodwill letter to incompetent hospital asking for them to recall the collection acct. as "reported in error". B) Ask CA to recall the collection acct. as "reported in error". or C) Contact all 3 CRAs and dispute? My insurance is being very cooperative and willing to send any info I need. I'm a bit wary of trying to correct things through the hospital because they have messed things up so badly in the past (not just this, but also made mistakes in sending records to our primary care doctor and other paperwork errors). Any consensus on correct first step? Thanks
If the original problem was created by the hospital claim billing to the insurance company, and the hospital has now been paid, then that is the basis for requesting that the negative reporting be removed from your credit reports. Your arguments are both legal, moral, and ethical, and the hospital is more likely to respond than the CA, who if they posted the account, will probably do whatever the hospital directs them. You were a customer of the hospital, and as a customer one of the services you expect them to perform in a professional and accurate manner is insurance billing. Their bill to you was not correct until they correctly submitted their claim, so they could get paid. Only then could you determine any remaining amount due and payable. Errors of this sort happen all the time, and they get fixed all the time, even after being sent to collection. You have to insist that they fix it, and raise a stink, up to their administrative levels, or thru your own doctor, if necessary. They didn't advertise "Come to our hospital, we'll patch you up, but screw up your insurance and credit." If they did, you would have gone elsewhere. You maintained insurance and provided your insurance information so that they would be paid promptly. Their obligation was to produce correct billing and claim submittals. Their errors reflect poorly on them, particularly if they haven't fixed the results, and they shouldn't reflect poorly on you. Was this hospital "in-network", and/or did they accept insurance "adjustments" reducing the billed amount from the original "list" prices?
I had a similar problem about 15 years ago. I first tried to be nice by calling everyone. (should have been in writing). I got it removed finally by getting the hospital billing department managers name and phone extension, then I told her I was calling the director of hospital adminastration to report her for decieving customers. It was gone pretty quick after that.
That is generally the most effective path. The layer of clerks that send accounts to CAs may give you the BS that you deserve to get dinged for their mistakes, or that once it is sent to collections, they can't do anything about it, the Accounts Receivable or Collections Manager may even go along with this, or do nothing, but as you go above that level, the hospital has an interest in keeping patients, and their doctors happy, avoiding disputes with insurance companies with whom they have contracts and do routine business, and staying out of court over disputes where they have nothing to gain. To upper management, problems that are not solved and smoothed over by lower levels, creating problems for them, indicate that those emplyees are not doing their jobs, particularly when the insurance and billing documents confirm that it was messed up. The fact that you have already worked your way up the chain, and sent your complaints in writing, indicates this is not going away until they fix it. As a manager, you don't get to just blame the employees under you without it reflecting on you too.
Our hospital use to send out a monthly paper and it listed community events. It said "Come golf with "enter head admin. name here" at his favorite golf spot "your town golf course" . So now I had his name and could use it like we were old golf buddies. Hopefully it will work out easier for you, I felt real bad after I chewed that manager out, but they left me no choice.
Good medical care is not provided by patching you up and sending you on your way, but messing up your life when they screw up the claims. Long term, good medical care depends on your finances, which depends on honoring contractual commitments to insurance companies, submitting accurate claims, and not destroying your customers' credit due to your own errors. Being poor, or having damaged credit, can kill you, by denying you access to adequate future medical care thru increasing your living expenses, or loss of your job or medical insurance.
Thanks for the helpful replies. Ontrack asked "Was this hospital "in-network", and/or did they accept insurance "adjustments" reducing the billed amount from the original "list" prices?" It was not in-network. This was an Emergency Department visit. My insurance allows me to visit any ED in the country (as it should). I don't recall whether they did any adjustments and I don't think it should matter. The fact is the hospital messed up the billing. They billed for an inpatient EEG when the EEG was done outpatient. My infant son had a seizure--that was the cause of the ED trip. I was too caught up in the implications of having a child with epilepsy to care much about this stupid billing mix up at the time. Now I see that it may be the cause of my credit card interest rates going up and my car loan being less than ideal. Since I intend to sell my house and buy a new one in the next year, I want this thing cleared up so I can qualify for a good interest rate. The only other negative thing on my credit report is "60 days late" on my student loan over a year ago, and this shows up only on TU. After I tackle the medical bill, this will be the next one to get taken care of. I'll start w. the hopsital billing administrator. If that doesn't work, I'm friends with a former doc from that hospital who still has connections there.
Move up the chain. Focus on the fact that they made a billing and claim error, that when it finally got fixed, they got paid, and that therefore they should remove their erroneous collection. Errors happen all the time. People fix them all the time. They should act in good faith and fix this.
Another thought that may help is calling the insurance co that paid the claim and ask them to contact the hospital on your behalf and advise the hospital that they need to remove you from collections/clear your report since the insurance has paid them. I work for an insurance co and spend 1/2 my day calling hospitals, MD's about these issues and I have gotten it taken care of 9 out of 10 times. If the hospital or MD is participating with your insurance even better they are contracted and are under a leagl contract with your insurance co to remove the item. The medical profession seems to be getting quicker and quicker in sending people to collections. Just a thought. It is a much quicker, easier solution. Keep calling the insurance co until you get a rep that will call for you. I'm suprised they haven't offered to already.
Even hospitals that are not in-network with your insurance will often adjust their claims to match the insurance schedule. They have a better chance of payment thru your insurance than they have from most of their uninsured patients. One of the roles your insurance company plays is to ensure that you have been properly and reasonably billed. The ones who get stuck the worst are the uninsured patients with some assets, and there have been some class action lawsuits and settlements involving hospitals overcharging uninsured patients.
