Dr. sent bill to collections; now wants me to bring money at next appt
April 20, 2014 8:09 PM   Subscribe

My doctor's desk person would like me to bring in the $50 I owe them plus the copay at my next visit. They'd already sent it to collections (a day after they received my partial payment according to her, but whatever). Now desk lady says I should bring it in and they will report it paid to the collections. "Or pay them" she added. Who shall I pay? Are there advantages to paying either? I wish he hadn't reported me for that and then turned around and asked me to being it in. I'm working towards a house someday and I am sure this sent to collections dinged my credit report.
posted by intrepid_simpleton to Work & Money (22 answers total) 1 user marked this as a favorite
they reported 50$ to collections? lame.

just pay the doc's office the money and be sure to get a receipt. if you continue getting letters from the collections agency, send them a copy of the receipt. then send a copy of the letter and a copy of the receipt to the doctor's office and tell them to take care of this shit.
posted by misanthropicsarah at 8:17 PM on April 20, 2014 [2 favorites]

Sounds like a shitty office with shady practices. Pay the collections agency, so that the doctor's office has to give them their kickback, and find a new doctor.
posted by Behemoth at 8:25 PM on April 20, 2014 [15 favorites]

No matter who you pay, you can appeal the ding to your credit report, and you should.

You should also get a new doctor.
posted by caryatid at 8:28 PM on April 20, 2014 [1 favorite]

Was the debt sent to the credit bureau or just sent to a collections agency? How old is the debt? If the doctor's office recently sent it to a collections agency they might not have reported it yet. The collection agencies inform you in writing that the debt has been sent to the credit bureau. Normally the person has received numerous calls and bills before anything is sent to the credit bureau.

If I were you, I'd pay the doctor's office directly and get a receipt asap. Make sure the person who takes the payment will inform the collection agency and find out when that normally happens. Most times it can be done online within two minutes, but that depends on how hi-tech the collections agency is.

For the partial payment situation, did you get a name of the person who you set that up with? If they told you that you wouldn't be sent to collections and and you were adhering to your payment plan schedule, you should ask that they remove your information from the collections agency asap, because you were holding up your end of the bargain.
posted by Attackpanda at 9:01 PM on April 20, 2014

If it's any solace, collections for under $100 aren't as damaging to your credit score than others. I believe that Equifax doesn't even count them at all.
posted by hwyengr at 9:02 PM on April 20, 2014

This happened to me at a doc-in-the-box a few months ago. If they've already reported it to a collection agency, I think that you have to pay the agency now because they're handling it on the doctor's behalf. If you pay the doctor directly now, the agency is still going to chase you down for it. I would not pay your doctor, and would probably start looking for a new one.
posted by pandalicious at 10:12 PM on April 20, 2014 [1 favorite]

I have also seen that some home mortgage lenders have a special category for “medical debt” when reviewing credit reports. That is not by any means universal.
posted by yclipse at 2:58 AM on April 21, 2014

It is possible that the 'collection agency' is just a front for the doctor's office to 'get serious' with you, that the agency is part of the office billing dept and just pretends to be a collection agency. I saw a doctor who was part of a hospital that did crap like this. For some reason I can't remember now I got ~$20 behind in my bill and was utterly shocked by a collections notice. I took it to my next appointment and the doctor explained the ruse and told me it would be a looooong time before they involved a real agency. Pretty crummy tactic but at least then, I was convinced the doctor was on my side.
posted by Tandem Affinity at 3:07 AM on April 21, 2014 [3 favorites]

Unpaid debts are sold to collection agencies at some margin [depending on the nature of the debt to be collected]. Some debts are more easily collected so are sold at a higher price, some are less easily collected so sold at a lower price.

"Are there advantages to paying either?"

Paying the doctor if the debt has been sold to a collection agency will not relieve you of your debt. I would not.

Debt collection laws are actually quite stout and generally well enforced. A letter to your State Attorney General can be suprisingly effective. [I know this as having been a recipient of a few letters from the AG - $50 is nothing compared to the cost that the governent can bring to bear].
posted by vapidave at 4:05 AM on April 21, 2014

I wish there were better ones in this area. Believe it or not he comes highly recommended (for his expertise, if not his compassion). I guess I put up with him because he returns calls. You're right though, I should probably look around.

And vapidave, I'm confused what I would say to the Attorney General.
posted by intrepid_simpleton at 5:08 AM on April 21, 2014

caryatid, are you talking about disputing something? If not, what would be the steps I would follow to appeal?
posted by intrepid_simpleton at 5:13 AM on April 21, 2014

I'd send a letter to the Doctor complaining about his billing practices. Tell him that you like him as a practitioner but that his front office leaves a lot to be desired.

The doctor sold the debt to a collection agency, he's already been compensated by them. I can't imagine why his front office is asking you for payment. I'd tell them, "Since I'm dealing with the collections agency, I'll pay them."
posted by Ruthless Bunny at 5:43 AM on April 21, 2014 [2 favorites]

There is a way to pay the debt and have it removed b/c HIPPA. I don't know the exact details but it is very searchable.

Check your credit report to see if it's actually been reported.

I believe that paying the original owner of the debt does not place you I not owing the collections company as well, but it will take extra paperwork and documentation that you in fact paid the original owner.

The fact that they are working with you and demanding the money indicates something fishy is going on.

As you can tell from the comments there are multiple ways of handling this and no way is the right way. It depends on your exact situation and preferences for paperwork.

In addition check your credit report and make sure they followed the laws (how much warning they gave, proper notification and that the bill is accurate) if not appeal it and it may come off your report.
posted by AlexiaSky at 6:13 AM on April 21, 2014

Not a scam.

The lady at the front office said "...or pay them"
In other words, she gave you a clear option of paying the collection agency directly. You owe the business money - dont get peeved at them. $50 adds up when 10 percent of their patients dont pay.Call the collection agency and ask: "have you reported this debt to any credit agency?"
posted by Kruger5 at 7:37 AM on April 21, 2014 [1 favorite]

IANYL - "Sent it to collections" may not mean any kind of external agency at all. Many companies have internal collections departments that handle bills that are past due. So first, find out who "collections" is. If it is an internal department, it does not matter if you pay them or the doctor's receptionist. Get a written receipt and have them inform the other department asap. An internal department is less likely to report it on your credit than an external one. They want you to pay the bill, but they also want to retain you as a customer of the larger business. Alienating you is not in their best interest, so use that to your advantage. Don't use empty threats, but do mention you are disappointed in how this chain of events went down.

If this is an external agency, you can still pay the doctor's office and have them remove the claim from the agency. Ask the office when you can expect the agency to be notified. If anything shows up on your credit report, dispute it with the term "billing issue".
posted by soelo at 8:06 AM on April 21, 2014

I've learned a bit about this because of researching a very similar scenario that I ended up in.

It's true that there's a recent scoring model for your FICO score that discounts collections of this size (original value less than $100). It's the FICO 08. Unfortunately it seems that not all lenders use this model -- in particular, unless it's changed recently, mortgage lenders use the FICO 04 which does count these sort of collections. Once a collection is on your credit report, it doesn't matter for scoring purposes (for other purposes it sometimes matters) whether you paid it or not, or what size it is -- it's just as bad in any case. So having the thing entirely off of your credit report or never on it in the first place is the best outcome.

Usually, once a thing has been sent to collections, you deal with the collection agency and not the original creditor. However, sometimes the original creditor has the ability to pull back collections from the collection agency -- essentially to undo the collection -- within some relatively short time window after it's made. If this is what the office person is proposing, it'd probably be a good idea to take them up on that offer. The advantage there is that the collection agency then has no right to collect on the debt or to report it to the credit reporting agencies -- if they do, you can dispute it and get it taken off. If this works, it would be the best outcome all around -- the doctor gets their money rather than a fraction of it, you are assured of not getting a ding on your credit, and the collector does not get money (I consider this a win, but YMMV). Make sure that you get all of this documented in writing --receipts for what you pay, et cetera. If there's a further mix-up, papers rule.

If this does not work and you the issue ends up definitively in the hands of the collectors, you're in a less advantageous situation but there are some techniques you can employ -- essentially, offering full payment in return for not having the thing reported, or asking as a favor that the thing not be reported. For how to approach that, I'd recommend reading the myFICO boards -- that seems to be one of the more reliable sources of information as far as how credit scoring and related processes work, and there are a lot of folks there who geek out massively over all the small details of this. I'd particularly do more reading before considering employing the "HIPPA method" -- what I read about this seems to be kind of conflicting, and the technique itself sounds odd.
posted by sparktinker at 8:17 AM on April 21, 2014

It's entirely possible that it hasn't been sent to an external agency. I worked for a doctor's office and we used "send to collections" as basically a mildly-threatening "this is your last chance" to get the patients to pay.
posted by radioamy at 9:46 AM on April 21, 2014

Agree that "collections" is not the same as "selling the debt to some shady company who will harass you and destroy your credit." I find the baseless assumptions that this practice is shady to be, um, shady.

This means that your Doctor's practice likely has an external company that sends out letters that say "you owe X amount, here is how to pay." It frees up their front office staff to handle insurance claims and scheduling.

Unfortunately there is a business side to being a Doctor --- which includes paying the bills to keep the office open.

Let the Doctor know when you see him/her -- they will take it up with their staff. It is that simple.
posted by LeanGreen at 11:26 AM on April 21, 2014

Regarding collectors, just to emphasize: Mr. Collector may love his cat and be viewed with indifference in return, but Mr. Collector is not your friend. Nor is he some trivial subcontractor of your doctor's office, to be viewed with no more prudent caution than the janitorial crew.

It'd be real hard to legitimately call me a deadbeat or less than upright with regard to my debts, but I have nonetheless dealt with objectively dishonest collectors (or, if that's too harsh, whatever one would call someone who tries to intimidate someone into paying a debt that is known not to be theirs) and I have been negatively impacted by situations involving collectors. In fact, I currently have a not-insignificant impact on my credit rating (which is nonetheless decent) from a scenario that in many ways resembles the one posed here.

In that last event, being unduly casual about dealing with my affairs is what did me in, and so I want to emphasize that while there is no need to be unduly stressed, to harbor resentment, or be anything less than polite and professional, it is important to be proactive in pursuing this matter, to determine who you can pay and who you should pay, and to get written documentation as to what you were told to do and what you did do. This may not amount to anything more than a few extra papers to shred in a few years, but it may also amount to a quick and easy resolution to something that would otherwise be more complicated and stressful.

Personally, I'd go to the doctor's office and talk to them in person, but I'm kind of bad on the phone and it's easy for me to deposit myself on people's doorsteps. In any case, I'd get back to this person ASAP and make sure that everyone is on the same page and that a page to that effect is winging its way to you by way of the mail, and get them the money as soon as humanly possible.

I mean, look, it's not like they're not going to appreciate having all of their money and having it now. And that's the right thing to do anyway.
posted by sparktinker at 6:42 PM on April 21, 2014

"And vapidave, I'm confused what I would say to the Attorney General".

"My doctor's desk person would like me to bring in the $50 I owe them plus the copay at my next visit. They'd already sent it to collections."

Sorry for the tardiness of my reply. I would ask your doctor for an invoice and then get your credit report that demonstrates that your debt was sent to collections. An organization that you owe can either charge for what is owed or send the debt to collections but not both. In the first place they are just trying to collect a debt, in the latter they sold your debt to a collection agency for which they are paid. If your debt was sold to a collection agency then the doctor has been paid - and gets a write off for tax purposes [It's a little more complicated than this but the gist stands]. They are in effect trying to bill both you and the government - which the government takes a dim view of.

Send the invoice from your doctor and your credit report reflecting that your debt was sent to collections to the Attorney General via registered snailmail.

[A sidenote, the Attorney General has a huge staff and they love shit like this.]
posted by vapidave at 6:42 AM on April 22, 2014

How long has this bill been past due? It is unlikely that a doctor's office is writing off money that you owe for an appointment in the last few months. If this bill was outstanding for a year, it is more likely that they have sold the debt and written this money off. Practices vary as to how hard an organization will try to collect on written off money.It is not illegal for them to try to collect it, as long as they report both the write off and subsequent payment properly on their taxes. You care about this affecting your credit. Ask them if it will, point blank.
posted by soelo at 8:20 AM on April 22, 2014

My wife works in medical practice management. Every practice is different, but over every practice she's familiar with:

1) If you've really been sent to an external collections agent (where it could hit your credit rating), you're probably more than 90 days past due on the original debt. The practice admin knows all about what the law is and what the Attorney General and a bad rep can get you. They aren't mustache twirling villains looking for any excuse to screw you because external collections is an admission that they'll never see more than a tiny fraction of the money you owe. My wife estimates that she sends accounts totaling something about 1-3% of total billing to external collections per month, depending on the office, and will often give up to 6 months of grace if there's an indication that someone is trying. Other practices are more strict, usually correlating with how many times they've been burned.

Fun fact: she say that she gets at least once a week "I didn't pay because doctors are rich and don't need the money" followed by a threat if they aren't seen/are sent to collections they'll sue/call the AG/report them to the medical board/post something nasty on Yelp. Only the last has ever happened.

2) If you've been sent to "soft collections", it's the practices internal group that deals with folks who either don't pay or can't pay their bill. It's so that there's a control over how much any individual patient can take them for, and it means the front desk people don't have a choice but to collect whats owed or to refer you to the billing team before the visit. The collections team generally work to find a manageable payment plan, and we know a couple of practices where they have people sending $20 month on multi-thousand dollar debts. It's much more important to pay something regularly than to pay erratically. And if you're going to be late, call the practice admin.

So, unless you're leaving out *a lot* of detail, "pay them" means bring what you're behind on ($50?) plus the copay you would owe for any visit and it will be fine. It's your prerogative to shop practices looking for slacker billing procedures, but expectation of payment on an agreed schedule is pretty common.
posted by kjs3 at 8:04 PM on April 23, 2014

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