Help me keep the hospital's thugs from breaking my kneecaps over $100 they seem to have lost.
July 24, 2006 2:01 PM   Subscribe

Is there anything one can do to fight a medical bill that appears to be incorrect? I visited the emergency room last fall. I paid a $100 copay at the time of service that appears to have never been applied to my bill. Despite several calls to the ostensible hospital billing office (really a cube-farm in Texas) pointing out some discrepancies, they've left the clock ticking, sent threatening notices, and are apparently determined to slash my credit rating if I don't pay *now*. What can I do?

I have a receipt and a bank statement for the payment that was given at the time of service. The sticky point is that the account number on the receipt appears to be associated with "another account." The ostensible billing office that is actually a contracted cube farm has acknowledged that it would not be standard practice to create separate accounts for the same date of service, however, rather than acknowledge this looks fishy, they've come to the conclusion I must have visited the hospital on two separate occasions. But because they are not actually the hospital, they can't verify this -- and in fact, they weren't willing to admit that they *weren't* the hospital until last Tuesday when, upon getting their threat to report me to the consumer credit agencies, I went semi-ballistic and got a phone call escalated to a supervisor who, however unhelpful in other respects, at least pointed me to someone else I could talk to at the actual hospital to try and track down further information (previous to this point, said cube farm denizens always told me if I contacted other hospital offices, I'd be referred back to them).

So I've contacted local hospital offices every day since. Wednesday I got a verbal acknowledgement from medical records that something is indeed awry and the two separate accounts appear to have the same date of service, and was told they'd call me back. When they didn't, I called back Thursday morning and I was told they'd have to refer the case to supervisor in order to get more information and documentation about what happened, and they'd call me back in an hour or two. When they didn't, I called and left messages Thursday afternoon and Friday morning. No response. Today's a state holiday and they're all out, so my plan to camp out in their office for a few hours in the morning didn't work.

In their notice last week, and in subsequent angry phone calls, the ostensible billing office has assured me that starting tomorrow, they'll consider it time to charge off the debt and report me to the credit agencies, and there's nothing anyone can or will do about it unless I pay them or show them proof I already have on the same account they're trying to collect on. This seems ludicrous to me, given that I have proof that payment went to a different account, I've payed every other bill down to the cent, and they have it on record that I've been talking with representatives since last November to try and find out what's going on. It should be obvious to a kindergartener that I'm not simply dodging them.

Is there anything I can invoke that might give them pause?

If I pay them to avoid even potential damage (which I'm considering doing since I'm close to buying some real estate, just finished cleaning up my credit report, and really don't want trouble), and later discover proof of the billing problem, what are my chances of/means for getting money back?

Are there other options anyone can think of?
posted by weston to Work & Money (12 answers total)
1. get a cease and desist letter off to the cube farm. if their calls aren't helping to resolve the matter, then stop talking to them. they only care about getting money.

2. get a supervisor contact name at the hospital. call that person daily, and present them with copies of your payment info. make it clear to that person that you will not stop calling them until this is resolved.
posted by lester at 2:20 PM on July 24, 2006

I've been going through some issues with a collection company trying to collect on fraudulent debt. (They claim I owe Cingular $185 and called my on my Cingular phone to tell me so.) The advice I've gotten so far seems to be that *nothing* can ever be resolved over the phone when it comes to collection agencies - especially the dodgier ones.

I'd start by writing a formal dispute of the debt, and sending it certified mail with return receipt requested.

I'm pretty sure that a hospital billing office is liable to the FDCPA (Fair Debt Collection Practices Act) rules, so here is some good information:

First, what they owe you

Second, some good information about debt collection, via Lifehacker

The primary advice I was given was *stop* talking to them on the phone. There are no records that way, and you'll find that you get a lot of lies and threats in the meantime that they would *never* put into writing.

Also, from what I'm told, paying up is an admission of the debt. I wouldn't do it, but I understand why you're concerned.
posted by squishy at 2:26 PM on July 24, 2006

Does the disputation of the validity of the debt have to be done in writing in the first 30 days? I've definitely disputed the validity of the debt at every contact I've had with them, but I didn't do it in writing until February, definitely outside of 30 days.
posted by weston at 3:01 PM on July 24, 2006

Yeah, if the phone is creating more problems than it solves I'd stop immediately and do everything with certified letters. Start the paper trail right now. I like the idea of an in-person office visit; I'd try that too. Alternately, what about filing a small-claims case? I'd do that in a heartbeat if I was peeved enough and they were within several hundred miles.
posted by zek at 3:38 PM on July 24, 2006


I don't believe so. Failing to dispute the debt doesn't necessarily make you liable for it. See item (c) under that first link.

You'll probably essentially be beginning the whole process again, this time in writing, but don't worry that you've waited too long. If you end up on the phone with them again, let them know you're going to be disputing it by certified mail, according to FDCPA regulations. You can (and probably should) ask them to stop contacting you by phone.
posted by squishy at 3:45 PM on July 24, 2006

Thankfully you're not in the 9th circus circuit where this is cut-and-dried but it's looking bad for all of us: folks in the 9th lose their right to validation after 30 days. The rest of us still have it (for the moment) BUT, and most unfortunately for you, after the 30 days they have to provide it but they are NOT obligated to "cease continued collection activity" until such time as they provide it.

So, at this point what you need to do is proclaim repeatedly - in writing - that you requested it verbally (which you are entitled to do, it's just foolhardy and reckless and impossible to prove) and still don't have it. Also, you need to issue a LIMITED cease & desist indicating that it's inconvenient for you to receive phone calls (that's the extent of the standard for FDCPA - you don't need a more elaborate reason) and all continued correspondence needs to be in writing.

You should also indicate in that same letter that since you have not received validation and do not believe the debt to be valid that you will consider all continued attempts to collect the debt, including reporting to any credit bureau, to be a violation of FDCPA and you will pursue compensation for those offenses as allowed for by statute.

Mind you, some of these protections hinge on whether or not this office is considered the original creditor, as you have no right of validation against the OC, just debt collectors. You may want to contact the Office of Consumer Credit Commissioner and see what they have to say.

You may also want to look at the Texas code about debt collectors. Happily you should notice that violations are privately actionable to a minimum tune of $100. The Attorney General's website may also be helpful.

posted by phearlez at 3:51 PM on July 24, 2006

Write it all down in excrutiating detail, in a dry, factual, just-the-facts-ma'am manner. Every time you write after that, enclose the ever growing copy of the correspondence. Call the hospital and see if they have anybody who can resolve billing disputes. Repeatedly state that you paid the actual copay for services, are being charged for for something you do not owe, and ask them to stop harassing you. Your state has an attorney general; ask for help.

Dealing with medical bills is a fulltime job - you have to become an expert in multiple large, complex, confusing systems. It's absurd.
posted by theora55 at 4:06 PM on July 24, 2006

Look. YOU HAVE THE MONEY THAT THEY WANT. This puts you in the driver's seat. For some reason people think that a creditor has power over you. They do not.

Do not pay. Tell them, in writing, to stop contacting you. You can also tell them why - the debt isn't valid - but that isn't even really necessary. Every question that AskMeFi gets about debt collectors goes the same way, the answer is the same every time. You're dealing with people whose job is to make you fear for something, your credit rating or your firstborn son's life or whatever they can. They have no power over you whatsoever.

Never ever talk to bill collectors for any reason. They have nothing you want. Let's say they called you, you put God on the phone, and He swore that you weren't responsible for the debt. Would that change the debt collector's behavior? No, why should they give up harassing you? If they keep it up, you might pay them anyway! You may, if you wish, contact the original service provider and try to resolve the issue.
posted by jellicle at 5:22 PM on July 24, 2006 [1 favorite]

Hospital guy here. You may have already considered this, but an ER visit can result in multiple bills: one from the ER, one from the doctor, maybe another from a radiologist. So it's possible that your $100 payment (and insurance) took care of one bill but not another.

Do visit the hospital in person if possible, with all correspondence. Ask for an itemized statement for both accounts, listing all of the charges and credits. You will probably need to go to the hospital's cashier or billing office for this, rather than to medical records.

If this doesn't resolve the matter, there's good advice above on sending a written notice disputing the accuracy of the bill, to both the Texas contractor and the hospital. You might also want to involve your insurance plan. Their contracts with providers prohibit the provider from collecting anything other than co-insurance, and they should be willing to intervene on your behalf. Unfortunately, many plans are even less customer-friendly than hospital billing offices.

If I pay them to avoid even potential damage... and later discover proof of the billing problem, what are my chances of/means for getting money back?

Getting a refund should not be a problem. But given your experience so far, it may require some persistence.
posted by Snerd at 6:06 PM on July 24, 2006

Hospital guy here. You may have already considered this, but an ER visit can result in multiple bills: one from the ER, one from the doctor, maybe another from a radiologist. So it's possible that your $100 payment (and insurance) took care of one bill but not another.

Snerd, thank you -- I especially appreciate hospital worker perspectives.

Your explanation occured to me, and both the hospital and their ostensible billing office have forwarded it as a likely explanation. I've been skeptical for the following reasons:

* I've already received separate bills from the Emergency Physicians and Ultrasound tech. The payment doesn't seem to show up there either.
* The receipt I have for payment is directly from the hospital itself as a business entity (also what shows up on the bank statement)
* The payment itself was described as a co-pay to the hospital required by my insurance plan. I may be wrong about this, but in my experience, that almost always constitutes a payment applied directly towards bills from the business entity operating the point of service.

If there's something I'm missing here that could mitigate any of these factors, I'd be happy to hear it so I can consider my case more carefully.

You're dealing with people whose job is to make you fear for something, your credit rating or your firstborn son's life or whatever they can. They have no power over you whatsoever.

jellicle, I'd like to believe this, but it would in fact seem that bill collectors who I've essentially ignored in the past have had the power to affect the rates at which I can obtain credit and therefore my overall ability to make certain purchases.
posted by weston at 6:43 PM on July 24, 2006

Frankly, I'd pay it. I don't know how much time you've already spent on this, but I imagine it could run well over 10 hours by the time you see it through to resolution (Certified Mail? Do you want to visit the Post Office?) and I know my time is worth more than $10/hr.
posted by Rock Steady at 8:34 PM on July 24, 2006

Rock steady - the problem with that is that if you do so there's nothing preventing them from then reporting it on your credit report as a paid collection, which seriously dings your credit score. That can cost WAY more than $100 on the life of a mortgage and it's effectively incontestable. There's no option for "it was bullshit but it was easier to pay it than fight it."
posted by phearlez at 9:44 AM on July 26, 2006

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