What is proper medical validation?

Discussion in 'Credit Talk' started by dixidriftr, Feb 12, 2003.

  1. dixidriftr

    dixidriftr Well-Known Member

    OK i'm getting ready to fire off some validation letters to some CA's for medical bills... what constitutes proper validation for medical collections?
    The way I understand it, a print out of the charges is sufficiant for validation. I know this has been gone over a bazillion times on this board, but at the moment I'm too lazy at the moment to spend a couple hours researching previous posts.
     
  2. bbauer

    bbauer Banned

    The best way I know of to think of that is this. The law says you have the right to dispute the debt or any portion thereof.
    If the validation you receive does not meet that standard then it isn't a validation at all.
    Does that prove that the debt is indeed yours? They have to prove all the facts the way I see it.
     
  3. bukethead

    bukethead Well-Known Member

    Bill states some excellant points, and while merely disputing a medical collection or past due with the CRA's will not always work. I have had excellent luck with getting CA to delete the account once I send a couple well worded letters. Alot of times the CA's have a hard time getting the discription of the procedures and the bill, due to patient confidentiality laws.. Which really dont apply in this.. but everyone is so affraid of getting sued, alot of doctors still will not supply that info to the CA, even though it is well within their legal rights to do so.
     
  4. bbauer

    bbauer Banned

    And that can also lead to the both of them getting sued. The CA for failure to validate and the doc under the law of agency.
     
  5. dixidriftr

    dixidriftr Well-Known Member

    One other thing, who is responsible for childrens medical bills after divorce, and if a spouse puts down the party not responsible as the guaranteer how do you deal with that situation?
     
  6. bbauer

    bbauer Banned

    My understanding is that both parents are equally responsible for the medical bills of their children. I furthermore understand that such is true divorce decrees not withstanding. The whole point as I think the law sees it is that the provider of the medical care is entitled to his compensation and in the event that there is disagreement between the two responsible parties it is not the responsibility of the provider to resolve the question of which of two parties are actually responsible or whether or not they are equally responsible. He is there to provide medical care and services and not to settle legal disputes between the parties. So your divorce decree and settlement is of no relevance in a debtor's court if it comes down to that.

    Just my personal opinion and that gathered from what I have read on the internet.
     
  7. dixidriftr

    dixidriftr Well-Known Member

    So if after you get divorced, and the divorce decree says that the father is responsible for the childrens medical bills, then the children have to go to the doc and the father puts down the mother as garantor, then the bill goes to collections the mother is stuck with the CA account record?
     
  8. bbauer

    bbauer Banned

    I suppose it could happen that way but most fathers would not think of doing that no matter how upset they may be with their ex. Seems to me that fathers might have a whole lot more problems with pulling that trick than mothers would however. Its been a lot of years now since I had to sign for my kid's medical bills but it seems to me that they usually want the responsible party to sign for it so whoever is bringing the kids to the doc signs for the whole thing not realizing that they just hung themselves to pay even though they are not the responsible party according to the divorce decree. I think its more of a case of mothers not stopping to think at the time and that very well may be because they are far more worried about the kids at the moment than they are about the financial end of it.

    I never really had the problem because my son is educationally handicapped so he was always on SSI so when he went to get cured I always put down SSI as the responsible party and showed the card proving elegibility and never had any problems until one tiime his coverage ran out for a few months and we didn't know about it or we would have had it renewed. So the account went to a collection agency and we fought over who was responsible for quite a long time.

    DHS finally came up and cooperated a little bit by claiming the fact of the lapse in the coverage so I just forced the collection agency to pay for the bill but they lucked out because the state had relinquished control of its teaching hospitals to one of the major HMO companies (or whatever it is they call themselves) and when they did the state just forgot about all the back bills so it ended up that the bill was never really owed anymore anyway.

    I'll bet the collection agency knew that all along and would have just pocketed the money that should have gone to the state. I'll bet they made a lot of money that way. And now the state is hollering about a budget crises.

    I'll bet that if the state ever woke up to the money they lost that way the collection agency might not be so well off.
     
  9. kathycmh

    kathycmh Well-Known Member

    Although you may not live in Ohio you still may want to read the statute from the Ohio Revised Code which I have pasted below. Of course all state laws are different but this might help you with your search of your own state laws.

    Anyone living in Ohio with a minor child who's ex is not fulfilling his/her obligation for medical insurance and payment may find the following information useful. The last paragraphs deal specifically with credit reporting:

    § 1349.01 Former spouse, children and person responsible for children not liable for medical costs where responsible party fails to obtain health insurance.
    Text of Statute


    (A) As used in this section:


    (1) "Consumer reporting agency" has the same meaning as in the "Fair Credit Reporting Act," 84 Stat. 1128, 15 U.S.C.A. 1681a.

    (2) "Court" means the division of the court of common pleas having jurisdiction over actions for divorce, annulment, dissolution of marriage, legal separation, child support, or spousal support.

    (3) "Health insurance coverage" means hospital, surgical, or medical expense coverage provided under any health insurance or health care policy, contract, or plan or any other health benefits arrangement.

    (4) "Provider" has the same meaning as in section 3902.11 of the Revised Code.
    (B) If, pursuant to an action for divorce, annulment, dissolution of marriage, or legal separation, the court determines that a party who is a resident of this state is responsible for obtaining health insurance coverage for the party's former spouse or children or if, pursuant to a child support order issued in accordance with sections 3119.30 to 3119.58 of the Revised Code, the court requires a party who is a resident of this state to obtain health insurance coverage for the children who are the subject of the child support order, and the party fails to obtain such coverage, no provider or collection agency shall collect or attempt to collect from the former spouse, children, or person responsible for the children, any reimbursement of any hospital, surgical, or medical expenses incurred by the provider for services rendered to the former spouse or children, which expenses would have been covered but for the failure of the party to obtain the coverage, if the former spouse, any of the children, or a person responsible for the children, provides the following to the provider or collection agency:


    (1) A copy of the court order requiring the party to obtain health insurance coverage for the former spouse or children.

    (2) Reasonable assistance in locating the party and obtaining information about the party's health insurance coverage.

    (C) If the requirements of divisions (B)(1) and (2) of this section are not met, the provider or collection agency may collect the hospital, surgical, or medical expenses both from the former spouse or person responsible for the children and from the party who failed to obtain the coverage. If the requirements of divisions (B)(1) and (2) are met, the provider or collection agency may collect or attempt to collect the expenses only from the party.
    A party required to obtain health insurance coverage for a former spouse or children who fails to obtain the coverage is liable to the provider for the hospital, surgical, or medical expenses incurred by the provider as a result of the failure to obtain the coverage. This section does not prohibit a former spouse or person responsible for the children from initiating an action to enforce the order requiring the party to obtain health insurance for the former spouse or children or to collect any amounts the former spouse or person responsible for the children pays for hospital, surgical, or medical expenses for which the party is responsible under the order requiring the party to obtain health insurance for the former spouse or children.


    (D)(1) If the requirements of divisions (B)(1) and (2) of this section are met, both of the following restrictions shall apply:

    (a) No collection agency or provider of hospital, surgical, or medical services may report to a consumer reporting agency, for inclusion in the credit file or credit report of the former spouse or person responsible for the children, any information relative to the nonpayment of expenses for the services incurred by the provider, if the nonpayment is the result of the failure of the party responsible for obtaining health insurance coverage to obtain health insurance coverage.

    (b) No consumer reporting agency shall include in the credit file or credit report of the former spouse or person responsible for the children, any information relative to the nonpayment of any hospital, surgical, or medical expenses incurred by a provider as a result of the party's failure to obtain the coverage.
    (2) If the requirements of divisions (B)(1) and (2) of this section are not met, both of the following provisions shall apply:


    (a) A provider of hospital, surgical, or medical services, or a collection agency, may report to a consumer reporting agency, for inclusion in the credit file or credit report of the former spouse or person responsible for the children, any information relative to the nonpayment of expenses for the services incurred by the provider, if the nonpayment is the result of the failure of the party responsible for obtaining health insurance coverage to obtain such coverage.

    (b) A consumer reporting agency may include in the credit file or credit report of the former spouse or person responsible for the children, any information relative to the nonpayment of any hospital, surgical, or medical expenses incurred by the provider, if the nonpayment is the result of the failure of the party responsible for obtaining health insurance coverage to obtain such coverage.

    (3)(a) A provider of hospital, surgical, or medical services, or a collection agency, may report to a consumer reporting agency, for inclusion in the credit file or credit report of that party, any information relative to the nonpayment of expenses for the services incurred by the provider, if the nonpayment is the result of the failure of the party responsible for obtaining health insurance coverage to obtain such coverage.

    (b) A consumer reporting agency may include in the credit file or credit report of the party responsible for obtaining health insurance coverage, any information relative to the nonpayment of any hospital, surgical, or medical expenses incurred by a provider, if the nonpayment is the result of the failure of that party to obtain health insurance coverage.
    (4) If any information described in division (D)(2) of this section is placed in the credit file or credit report of the former spouse or person responsible for the children, the consumer reporting agency shall remove the information from the credit file and credit report if the former spouse or person responsible for the children provides the agency with the information required in divisions (B)(1) and (2) of this section. If the agency fails to remove the information from the credit file or credit report pursuant to the terms of the "Fair Credit Reporting Act," 84 Stat. 1128, 15 U.S.C. 1681a, within a reasonable time after receiving the information required by divisions (B)(1) and (2) of this section, the former spouse may initiate an action to require the agency to remove the information.


    If any information described in division (D)(3) of this section is placed in the party's credit file or credit report, the party has the burden of proving that the party is not responsible for obtaining the health insurance coverage or, if responsible, that the expenses incurred are not covered expenses. If the party meets that burden, the agency shall remove the information from the party's credit file and credit report immediately. If the agency fails to remove the information from the credit file or credit report immediately after the party meets the burden, the party may initiate an action to require the agency to remove the information.
     

Share This Page