Hospital sent a bill to collection agency

[Zillionaire]

Insurance company refused to pay $2500 for hospital service cost because she cancelled her insurance 2 months after the service date. So hospital sent her a bill and she didn't pay for it. Now the money collector jumped in. It has been 5 years and now she wants to clear it out. Does anyone have any ideas?


Thanks

[boosami]

I assume she has already tried to dispute it with the fact that she was covered by insurance when the services were rendered... If she is unable to dispute it and have it removed entirely, she may not have to pay it all.

Since it was 5 years ago, she should be able to settle for a lower amount of money. You can usually settle for .50 on the dollar, and work out some kind of monthly payment plan to pay it off. Whatever she does, get it in writing from the collector, and do not give them direct account access or they might take the money right out.

[boosami]

In case she hasn't tried to dispute it...

1. Write a letter to the insurance company disputing the debt because of existing coverage at the time.
2. Write a dispute letter for the colletions to each of the three credit bureaus. Indicate that the debt is not hers and is in error.
3. Send a letter to the collection agency stating that she no longer wishes to be contacted about the debt. Under the FDCPA, they legally have to comply.

[arthurb999]

I don;t understand why the insurance company wouldn't be responsible?

[Zillionaire]

She has called her insurance company and they told her that her name is no longer in their system. Thanks for the great tips boosami.

[boosami]

Congratulations! Make sure she follows through with step 2 and removes any derogatory remarks from her credit history, if there are any. Collections can hurt your credit score 100 points or more. Once removed as erroneous, the score will improve immediately as if they were never there.

[lennygaudy]

I just disputed a medical bill collection from my mom's credit report yesterday. She went to this hospital's ER but left to another hospital because they were taking way too long and she couldn't take the pain. Despite not having rendered any services they billed her the $50 co-payment which she of course refused to pay and without notification apparently reported it to the credit agencies.

Anyway Transunion replied this morning that they had completed their investigation of the dispute and deleted the collection from her report, they even provided an updated copy of her credit report without the collection account. She has yet to hear from equifax and experian but hopefully they'll also agree to delete it.

[southerndoc]

That is common practice at nearly every hospital.

If you present to the emergency department and interact with the triage nurse or register to be seen, you will be billed a "facility fee" that is the base rate for the emergency department.

You will NOT be billed for the physician fee, a level of service, etc.

This is why once you register, you should stay to be seen. I work in a very busy emergency department, and sometimes we get waiting times in excess of 3-4 hours. People will often sign in, see the wait, leave, go to another ER, realize the other ER's wait is longer (we're actually one of the better hospitals for wait times), and then come back to our ER and re-register. They receive two facility fees, and often times their insurance company will reject one of the bills leaving them responsible.

As an emergency physician, I apologize for the wait times. I feel sorry for people needing to wait while they are in pain, short of breath, etc. However, there are numerous reasons why the wait times are long:

1. There aren't enough hospital beds upstairs. When patients are admitted during a bed crunch upstairs, beds in the ER are taken up. Nurses can only care for so many patients at a time (both for safety as well as nursing regulations). There are times that I sit around surfing the web with nothing to do while there are a ton of patients in the waiting room. The triage nurses are too busy for me to see and discharge patients in triage (they can barely keep up with the triage requirements), the nurses in the back are already overworked from admissions and current ER patients, and there just isn't any place to see them.

2. As patients lose insurance, the ER becomes their safety net. Our ER volume has increased over the past few months while our payor mix has decreased. We are seeing more and more "self pay" (sometimes "no pay") patients.

3. Because of financial constraints, many hospitals no longer offer emergency services or have closed their hospitals entirely. While ER volumes around the nation have increased steadily over the past few years, the number of ER's and the number of ER beds have decreased. This increases wait times.

4. Medicare reimbursement, and subsequently HMO reimbursement, has gone down for emergency services. This will force more hospitals into financial constraint, and may end up closing more ER's.

Why do I mention this? People should write their state legislators to advocate more hospital beds, better Medicaid (so those patients are cared for appropriately in clinics), and better nursing scholarships to attract more nurses to eliminate the nursing shortage.

[boosami]

She has yet to hear from equifax and experian but hopefully they'll also agree to delete it.

All the agencies go through the same procedure to validate an alleged debt, so I'm sure they'll have it removed as well.

[Scanner]

Don't forget your state's DOBI (dept. of banking and insurance) is a resource. YOu can file a complaint online usually and at least in NJ, they do open up a file and look into the matter.

If she was insured at the time of service, the ins. co. should be paying but then again, I am not sure of the statute of limitations on this. At some time, an ins. co. will consider a claim closed.

[Scanner]

People should write their state legislators to advocate more hospital beds, better Medicaid (so those patients are cared for appropriately in clinics), and better nursing scholarships to attract more nurses to eliminate the nursing shortage

The problem I understand with nursing isn't attracting nurses, it's the lack of educators. Our local nursing program is not short of wannabes, but their applicant to seat ratio is like 5 or 7 to 1.

Every nursing student is assigned to a hospital and that takes staff/educators to do that. So that's why a nursing class may only have 20 or 25 students tops. It's a lot of work to nuture them, frankly - a lot of the seasoned nurses don't want the hassle. They need dedicated educators.

The same thing happens in rad. tech, but to a lessor degree. The applicant ratio is like 3 or 4 to 1, not as demanding but the same problem - they have to cap class sizes.

[lennygaudy]

This is why once you register, you should stay to be seen. I work in a very busy emergency department, and sometimes we get waiting times in excess of 3-4 hours. People will often sign in, see the wait, leave, go to another ER

southerndoc thanks for your input but in this case I was there when this incident occurred and it was truly ridiculous, there was nobody in the waiting area (it was very late on a holiday) and still aside from making a copy of my motehr's insurance card nobody came to even speak with her after sitting there for nearly two hours. I understand if there is a long wait there's only so much they can do but the staff at this hospital was really rude, uncooperative and unhelpful (this is very common in Miami unfortunately).

And its not as though we got up and left without notifying them, we did go to the girl in the front (the one who signed us in) to let her know we would no longer be needing service and alert her that we were going elsewhere. The bill was issued as "co-payment" not "facility fee" and even if it had been they didn't deserve one penny given their treatment. This hospital is literally in the corner of my house and I'd rather drive to one miles away before stepping foot in this place given my own past experiences (they nearly killed me once after that) and horror stories I've heard from others.

[lennygaudy]

All the agencies go through the same procedure to validate an alleged debt, so I'm sure they'll have it removed as well.

Thanks boosami, I sure hope so.

[lennygaudy]

All the agencies go through the same procedure to validate an alleged debt, so I'm sure they'll have it removed as well.

Just heard back from Experian and unlike Transunion they refuse to delete the account. They claim it's been "verified" whatever that's supposed to mean. Now let's see what Equifax does-apparently they don't use the same procedure. Im going to have my mom send in a debt validation letter to see what they can actually provide as evidence since no services were rendered.

[boosami]

Just heard back from Experian and unlike Transunion they refuse to delete the account.

In that case, TransUnion may just have not received proof of the debt in time for their case to be completed. If the creditor does not supply proof within 30 days, the debt must be removed. Perhaps they did not respond quick enough to TransUnion, but have been quicker with Experian.

It's unfortunate, but the creditor seems to have proof you owe them a debt, and you will have to pay it off to remove the active collection from your report. If they have proof, and you've can't disprove them, you have no other options.

My advice? Pay the $50 and stop prolonging this mess. From other comments, it seems charging the copay even if services are not rendered is common practice and legal, even if you don't believe it is right. What's unfortunate here is that it's now been verified as legit and cannot be removed from the Experian report.