Received Medical Bill from Collection company

[krielly]

My son, now 18, was in substance abuse treatment facility last year. Long story short, they took him to an outside facility for lab work. I began getting a bill (in his name) at the time a few months later for $115.

I ignored it for a bit, as our insurance sometimes takes a while to pay (should have been paid in full, minus a $15 co-pay.)

Well, about 2 mos ago, I got another bill - threatening to send it to collections, so I called. The practice told me I needed to call a different number than the one on the bill, as they had just changed billing companies. When I called the number they gave me, they had no record at all of this bill, or of my son's name, address, etc........ YET, they had sent a bill........

Now - 2 mos later, I'm getting a bill from collections. I don't think this was ever submitted to insurance, as I had advised them months ago.........

Now what????? No one could help me when I called 2 mos ago, as they had no record of even sending me a bill........now's it's in collections!!

Thanks
Karen

[catleg]

I'd suggest you try this. Call your insurance first, tell them, I'm having a problem with such and such a provider. Give the insurance person all the information, the billing phone number, your account number from the bill, and of course the date of service. Ask the insurance person to call the health care provider and work it out. They can do this while you're placed on hold.

I did this with Aetna and a rather large hospital bill after a surgery. It took about 5 months for the medical review to happen, but putting the insurance in touch with the service provider is key to getting them off your back (and getting your account out of collections.)

[krielly]

Catleg,
Thanks so much for your advice. I hadn't even thought of pursuing it at that end. I will do that!!!

Happy New Year!
K

[catleg]

I always try to solve my problems by making them someone else's problem.

[anime-chicka]

I'd suggest you try this. Call your insurance first, tell them, I'm having a problem with such and such a provider. Give the insurance person all the information, the billing phone number, your account number from the bill, and of course the date of service. Ask the insurance person to call the health care provider and work it out. They can do this while you're placed on hold.

I did this with Aetna and a rather large hospital bill after a surgery. It took about 5 months for the medical review to happen, but putting the insurance in touch with the service provider is key to getting them off your back (and getting your account out of collections.)

I definitely approve of this route, especially since most if not all insurance companies have departments that specialize in this. I had to do that with my insurance in 2007, two months before my wedding, because the doctor's office I used decided that since the insurance was slow to pay I should pay the late fees.

This ended up with me conferencing in with the department and the billing department of the doctor's office and I finally burst into tears and told them that they were ruining my wedding (it was a very stressful time, and I'd finally had it with the run around). The next day I got a call from the insurance company rep telling me the fees had been taken care of and to wish me the best for my wedding.

[krielly]

Update

Well, took the advice, and contacted my insurance company. I didn't get too far, because they needed a date of service, which I did not have from either the OC or Collection Letter.

So, I took a really deep breath, and called the collection agency. I explained the situation, and she was very very nice. She was able to get me the info I needed and let me know about all of the dates this bill had been submitted, and told me about all the diff notes on the file about insurance refusing to pay for incorrect codes.

I asked her if this had been submitted to the credit bureau (it was in my son's name), and she said it had not been yet.

Called the insurance company, and they found the claim. Turns out it was rejected and resubmitted twice again by the provider. Rejected both times, because the diagnosis code they submitted was specifically a "female" diagnosis code, rather than a "male".

So, I called collections back and left a message with the woman I spoke with what the issue was and told her insurance advised they will pay, but not until a corrected diagnosis code is submitted.

I can't believe the woman I talked to at collections was so nice......I'm dumbfounded!!!!!!

K

[Magikk]

If the health care provider is contracted with your insurance company, they should never bill you unless the insurance tells them to. Regardless of contracted or not, they should never bill you because they screwed up the diagnosis code. Obviously the billing company is at fault and you could even report the mistake to the provider to let them know their billing company is incompetent. Often the providers aren't educated in billing, hence why they use an outside company.

[krielly]

Yes, and in this case, they DO use an outside billing company (who apparently is incompetent!

[catleg]

I don't know which is funnier, the dunning letter with no date of service, or sending the same (wrong) code to insurance over and over again thinking it should work. This is the sad thing about healthcare, doctors pay their staffs like nothing to try and keep their incomes up. And yet the surgeon who did my 4 hours of brain surgery got less than the gas passer. Go figure that. (I think he got a secret kickback embedded elsewhere in the bill, fortunately).