I am in need of the groups counsel. I am absolutely outraged at what I received in the mail today. I cannot describe strongly enough my disgust. On October 21 I receive a call from a CA located in TX. They claim they have been assigned the task on collecting a medical bill. They insist that the bill is $11,000. I did incur a medical bill earlier this year that totaled in excess of $192,000. My medical insurer has a contract with the hospital. In that contract, the hospital wrote off $91,000. My portion of the bill was suppose to max at $2,500. Then my insurer was suppose to pay the balance. After discharge I receive a bill for the $2,500 and I begin making payments of $100 per month. That is all I can afford at the moment. No problem, I make a payment, receive statement from hospital, balance is reducing. At 4 months after making payments, get a call from hospital business office, they demand payment in full. I cannot do that. They say they will take it in 3 WEEKLY installments. I tell them Iâ??ll keeping on my current payment plan. Then I start getting statements from the hospital in which the balance is increasing. I call. They say my insurer is denying coverage and it is my responsibility. I tell them â??no wayâ?. I call insurance company, my file is under review and they will contact me. Still have not heard back, even after repeated calls. Then comes the CA call. I social engineer their fax number from the woman that called. I fax a Demand for Validation, then FedEx the original. In todayâ??s mail I receive an envelope that is almost 2 inches thick. I know this is not good. After reading its contents, I was utterly shocked and totally floored by what I read. It was my entire hospital history, from admission to discharge. Minus the forms that you sign for promise to pay, consent to treat etc. It gets better. The cover page is a screen dump from the CAâ??s database. It includes my entire insurance information, notes from when the CA did an asset search, all my credit information, it even included information on my BK from 1985. I pulled all three reports, but there is no inquiry from the CA, so how did they get this information without generating a hit on my reports???? Following the CA stuff is the original information the hospital provide the CA. It is the original not a photo-copy. It was printed on a dot matrix printer. It includes all my surgical notes, even the notes from the surgeon in which he was concerned that I might not make it. It includes all the pharmacy stuff, down to the last minute detail. What outrages me the most, in my validation letter I told the CA they did not have my permission to obtain medical information, only the consent to pay. The hospital supplied the CA with this information on September 16, 2003, over a month before the CA even contacted me. I already have the CA on several violations already, they are not registered in my state, the state of TX has dissolved the corporation, their initial letter to me does not meet statutory requirements. I know there has to be a MAJOR HIPPA violation here. I want them to pay, I what the hospital to pay. I want people to loose their jobs over this and I want jail time for someone over this. I am thinking I should let an attorney have this. What other violations do you see and how should I address this?
Nah, don't go there Enigma. It's a huge mess. lol We've already been trhough it anyway. Here's some background work which may give you some ideas: http://consumers.creditnet.com/straighttalk/board/showthread.php?s=&threadid=40803&highlight=hipaa We know what the HIPAA violation is here but we're not sure quite what, if anything, we can do about it, other than just file a complaint. I'd venture to say a good long talk with your Ins. Co. would reveal they are at fault. Often when that happens they get real slow at returning calls. Have you studied your ins. contract? Does it guarantee no liability above $2,500? The hospital was accepting 100 a mo. Keep paying that in the meantime. I'll get back to ya.
ok, their are several different ways to look at this. is it an internal collection agency (owned by creditor) or a hired CA? did they sell or assign the debt - if it was sold the CA, the CA would have all that information; if it was assigned they would only have name, address, amount, etc and it would be a hippa violation for them to have it. before jumping on the lawsuit bandwagon, those are some things you would need to find out. also, rather than sue - use it to your advantage to negotiate a better deal for you. they may be violating a fdcpa or hippa rule - which would award you about $1k; the ftc, etc, would be able to assess them tons of penalties and reap the rewards to the tune of thousands of dollars and you may never receive a dime.
sure it does, assigned means the ca doesn't own the debt and has no legal right to personal information if they bought the debt they have access to everything
Re: Re: HIPPA Violations - I need advice Not in the case of medical information. From what I read from the govt websites and a few others. the only thing a medical provider can give to a CA is name, address, ssn, phn, total bill amount, last payment and balance due. In this case the hopsital provided a third party CA my COMPLETE medical file. This CA is not licensed in my State, they have to be, they are not even bonded in their own State. I have a enough violations on the CA to bury them. BUT, I want the hospital to beg me for mercy on this. I've already talked to an attorney, will see him on Monday. The sad thing is that as a consumer of medical servicees, we do not have a right of private action under HIPPA. But the attorney said we have recourse under state law. I am going to get REAL VOICAL on this. I am going to get this out to the press and make some noise. This is just not right. I may nor be able to recover any money, but I am going to make some people loose sleep over their transgressions.
I continue to pay the hospital and they are accepting the payments. I've opened a seperate account at another bank just for them. I had the bank to disable the ACH feature on my account just in case the CA attempts to withdraw all the money at one time. Instead of making the check out to "Hospital Name", I now make it out as "Hospital Name ONLY" which should prevent the CA from cashing the checks if the hospital should forward them to the CA.
There are a number of different ways to make an agreement with someone. Certainly we all know about a written contract. But another way is to acquiesce to an agreement as evidenced by ones behavior. Example: Tenant gets into the habit of paying his rent 20 days late because his employer changed the pay structure. After some period of time goes by where the landlord accepts the late payments without disputing, it becomes an acceptable (UNspoken) agreement between the 2. Suddenly after 6 consecutive late payment acceptences the landlord tries to evict because the tenant is "perpetually late." Court will not allow it. It's called Estoppel by Latches. Just keep up the good work, and in the meantime we can formulate a strategy on the rest of it. .
Re: Re: HIPPA Violations - I need advice if they bought the debt they have access to everything Except your personal medical information. The hospital is in violation here for giving the CA his personal medical information wither they sold or assigned the account to the CA. quote: -------------------------------------------------------------------------------- Originally posted by jenz if they bought the debt they have access to everything -------------------------------------------------------------------------------- No they don't because if they really did they would be able to validate much more often than they do.
Re: Re: HIPPA Violations - I need advice if the CA bought the debt from the original CA how would they be able to validate it without ALL information? most OC's don't sell the debts, but some do, and that matters in whether or not its HIPPA violation. Also, did the package come from the CA or the OC (check the address). just because the letter was in there doesn't mean that the oc didn't send it. many times if you send validation letter, the ca contacts the oc to send you the validation and in that scenario it wouldn't be a hippa violation. before threatening to sue or attempting to sue contact a good lawyer who can advise you. also, if your a law buff, check out state/federal statues and rules and read up on case laws.
Many timeswhen you send the ca a validation letter, the ca contacts the oc to send you the validation and in that scenario it wouldn't be a hippa violation. jenz ========== According to The FDCPA [color=red([/color]for both assigned and sold accounts) the CA must obtan the validation from the OC and forward it to the consumer.The CA can not contact the OC and have the OC send the validation directly to the consumer.
Re: Re: Re: HIPPA Violations - I need advice Where in HIPPA does it say HIPPA only applies to assigned debts or that sold debt are excluded from HIPPA?
Re: Re: Re: HIPPA Violations - I need advice I thought I was clear in my post. I was contacted by CA on 21 Oct, fax and FedEx validation same day. On 8 Nov I receive package from CA. The information according to the time/date stamp on the print outs is from 16 Sept. The cover letter from CA said they contacted hopsital. They LIED, the hopsital sent the informaton to the CA prior to my demand. I may not be able to get CA on HIPPA, but I have the following violations: 1) Did not contact me within 30 days of receiving assignment from hospital. Does not matter if hosptial sold it or not. 2) Not licensed in my state. 3) Letter does not contain statutory disclosures. 4) CA not bonded in home state. 5) CA corporate structure dissolved by home state. 6) When CA called me did not give mini-miranda. I doubt the CA has "business arrangement" in place with the hospital. I have contacted an attorney that I referred to by our family attorney that deals with HIPPA issues. At first blush, he (attorney) told me that i do not have a right of private action under HIPPA, but we do have recourse under my state's laws. Money is not what I am after. The bill is mine. I do not dispute that. I am however disputing the amount. There are several thousand dollars that my insurance carrier should have paid, did in fact pay, but demand a refund from the hospital. The hospital probably gave the refund to prevent the insurance company from with holding other payments. I've gone round and round with my insurance company. Now it is time to bring in the big guns. What the hopsital did is just not right. Even if I cannot sue, I am going to cause some people to lose sleep over this. If my attorney agrees, I plan on getting real vocal over this. I plan on contacting my local papers and my local tv news.
Re: Re: HIPPA Violations - I need advice Butch, When I first read this, it did not click. But it does now. I'll continue to pay as usual. Should they attempt to sue, this will make a nice little defense.
Re: Re: HIPPA Violations - I need advice I have posted this before but I just don't see HIPPA as any sort of tool to use against an unruly CA or OC unless there is blatant and irresponsible disclosure. HIPPA protects what is known as "Protected Health Information." It is typically personally identifiable information and generally covers your entire medical record. The problem, however, is that HIPPA provides for use of PHI during collection of payment. That said it does require a "minimum necessary" disclosure but when you request validation that means they must provide to you a full accounting and that requires pretty substantial disclosure. In any event a significant part of your medical record was provided to the insurance company to procure payment and this is not illegal. As long as the CA has a "Business Associate Agreeement" with the hospital and takes steps to protect the PHI while it is in their posession they have no liability to you in this instance. You requested a full accounting of the bill and they provided it. The chain of custody is complete and as long as the appropriate agreements are in place no law was broken. The only argument you could make would be excessive disclosure. It might not have been necessary to send your procedure notes and transcripts but at the same time the CA was attempting to comply with *your* request for full validation. As the CA is a covered entity and is part of the payment and collection process I don't see how it can be argued that they violated HIPAA by complying with your request for validation. I am sure the Courts or the Congress would not permit a situation where a CA cannot collect on a bill because they can't send validation because they would violate HIPPA. That is why HIPPA contains an explicit exemption for collection of payment. IMHO you are better off pursuing the CA with an FDCPA argument and to continue paying the hospital the $100 per month. Also keep on top of your insurance company and demand to know why they didn't pay the bill resulting in your going to collection. You might be able to intimidate someone with a HIPPA argument but I doubt you'd win in Court.
Re: Re: HIPPA Violations - I need advice 1*As the CA is a covered entity and is part of the payment and collection process I don't see how it can be argued that they violated HIPAA by complying with your request for validation. 2*. It might not have been necessary to send your procedure notes and transcripts but at the same time the CA was attempting to comply with *your* request for full validation. slykens ============== 1*The CA isn't the violator it's the health care provider. 2*No there was no excuse for it.It wasn't need in order for the CA to furnish the poster proper validation.The hospital is still in the wrong for giving out this information to the CA.
Re: Re: HIPPA Violations - I need advice where in the fdcpa does it state about oc and ca? i can't find the information you posted about. also, read the part about Relation to State Laws and Exemption for State Regulation. That is one thing i haven't seen posted - what the state laws are in regards to the FDCPA.
