Is the alleged debt consistent with the patient co-pay as reported on your insurance Explanation of Benefits (EOB)?
Acutally, I received more information from them and the insurance I provided to them at the time of service, and the insurance information on the alleged bill I received from the CA, are different, and gives an explination that I had no insurance. Well of course not, I have no idea where they got that insurance information at. I just noticed that today with the documents they sent me, so I will email them and ask them what the deal is. If they refuse to respond, what should I do next? Insurance I assume wont do anything since this is from 04/05.
"Insurance I assume wont do anything since this is from 04/05." Do not assume this. Contact your insurance company anyway. They may still reach a settlement with your insurance company, even though the claim is being filed late, based on the date the original erroneous claim was filed. In addition, if the medical provider was in-network, and had a contract with your insurer, they may be bound to accept payment based on the terms and according to the payment schedule provided for in that contract, or they may just be out of luck if they have filed their claim too late. Insurance contracts with providers generally provide that if the claim is not submitted timely, the insurer is off the hook, and the patient is, too. Insurers may also have more leverage in settling this with the provider even if they are NOT in-network, since they are involved in making on-going payments to many providers, and they both have an interest in maintaining good relations. This debt was a result of THEIR billing error, and that is your basis for demanding that it be removed from collection. If the provider is in-network, that is the legal basis for your insurer to require compliance with contract, including the possiblity of waiving the debt, if that is what the contract calls for. If they DID screw up, they will of course prefer to blame it on you and demand payment from you based on uninsured rates. If they are in-network, to do so is a breach of contract which your insurer can use to force a reasonable settlement, including removal of any negative credit reporting based on their error. Keep in mind that if this is the case, the provider may not want to correct and recognize this as legally uncollectable. In addition, the CA will similarly not have any interest in your insurer stepping in, as they stand to get nothing. Your insurer may still have the right to enforce their compliance with contract, regardless of what the provider or CA want. Regardless of what they say, and in particular, regardless of what any CA says, these situations are fixed all the time.
I replied to them and pointed out there error and gave them until 4-27 to remove the account from collections, remove from my credit report, write me a letter detailing the above has been done, and to refile with the correct insurance as was given to them at the time of the appt. Anything I missed? What do I do if they dont respond?
So the Dr. office didnt reply back to my letter and the deadline. What do I do now? I'm still trying to find out my insurance information, as it was a short term medical policy while I was waiting for my employer insurance to kick in.
