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Problem with a medical bill...
Old 05-18-2009, 05:39 PM   #1
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Problem with a medical bill...

DW went to the doctor last November for her annual physical. She paid for the $125 co-pay while at the doctor's office, using her credit card. The credit card was charged and the transaction showed up on her statement as expected.

In February, we received a letter reminding us that we still had not paid the $125 co-pay. I called the doctor's office to let them know that we had already paid the bill in full but they could not find any trace of the transaction. After telling them I had the credit card receipt proving that they had already been paid, they told me that they would make the necessary adjustments to her account. I thought that everything was straightened out.

Last week, we received a final notice, stating that unless we paid immediately, the bill would be sent to collections. I have tried and tried, unsuccessfully, to get their billing department on the phone since last Wednesday. Nobody seems to know where the person in charge of billing is or when I will be able to talk to her.

I am running thin on patience. I am thinking about sending them a certified letter. I would attach a copy of the credit card statement (edited to keep irrelevant information private) showing that the bill has already been paid in full.

Question: how strongly worded should that letter be? On one side, I would like to keep it friendly, hoping that they get the message and make the necessary adjustments without further prodding. On the other side, I am afraid that they will dismiss a friendly letter and send the bill to collections anyways. I want to make it very clear that if they ruin my wife's credit there will be consequences. I am not going to roll over and pay for them to go away. I will fight them every step of the way and refer the matter to the proper authorities if I have to.

For the legally-inclined individuals among you, are there any legal defense against businesses trying to collect on bills that have already been paid?

Thanks. FD.
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Old 05-18-2009, 06:20 PM   #2
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Sounds like you hold all the cards. Have you tried escalating to whoever the right person is........supervisor of billing, the doctor, etc? I don't know who that is but that would seem to be key........I've always found 2nd level people to be more able to see the global picture than first line folks.

If you do write that letter, I'd be inclined to keep it cool and business-like. No need for emotional hysterics but you could surely figure some way to show that you have sharp teeth/claws if need be. Good luck.
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Old 05-18-2009, 06:28 PM   #3
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Bill

If the office is not too far away, could you not go in person with the proof of payment? I'm sure the staff would hurry to hush this up from people in the waiting room and resolve the matter amicably.
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Old 05-18-2009, 07:00 PM   #4
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Thanks to both of you. I am rather a quiet and reserved guy and I have taste for neither hysterics nor scene making, but a pointed, professional letter, phone call or face-to-face meeting is right up my alley. Going there in person would be great, but we are both too busy right now to make it during business hours. And at this point, I would prefer to keep written records of our exchanges... Just in case. I have not involved the doctor in this yet because the mistake is not his and he probably has better things to do than to track billing errors. But if I keep hitting a wall, I will.
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Old 05-18-2009, 10:04 PM   #5
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Many years ago, I had a similar issue which I tried to resolve via letters to the office which were dismissed. Then, I sent a letter explaining the details to my state's Attorney General's Office and the local Better Business Bureau with a cc: to the office. This was not very friendly; but, it was extremely effective, the office resolved the matter immediately.
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Old 05-18-2009, 11:14 PM   #6
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Hi Cool,

I was actually thinking about adding the following sentence at the end of the letter:

" Should your billing department persist in sending reminders for this bill or send this bill to collections, I will be forced to report the matter to the office of the Attorney General for the State of Alabama and other competent authorities."

But I felt that the warning was a bit too stern and antagonistic... What do you think?
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Old 05-18-2009, 11:28 PM   #7
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After telling them I had the credit card receipt proving that they had already been paid, they told me that they would make the necessary adjustments to her account. I thought that everything was straightened out.

Do you remember the name of the person you talked to?

I've found that when you know the name of the person that made you "promises" and it doesn't work out, if you direct the error to their attention, they will take care of the problem.

If you don't know who you talked to, you may want to call and get a person's name that is responsible for accounts receivable. Then send your certified letter to their attention. Someone dropped the ball along the line. IMO, a factual letter detailing your experience and asking for help may get it taken care of ..... without negativity and further "action" mentioned by you.
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Old 05-19-2009, 08:03 AM   #8
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I don't think there is a person alive who hasn't been involved in some medical billing nightmare nor a $125.00 discrepancy is going to ruin a credit rating. The worst that could happen is that it goes to collections, someone then calls you and chases you to get it resolved and in the end you have proof of paying the bill. I would try and resolve it as you are but there is a limit to the amount of energy expended on billing incompetence. I would at least try and find an email address that could be utilized for documentation purpposes.
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Old 05-19-2009, 08:18 AM   #9
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This may not be the doctor but a subcontracted administrative support function. It is quite typical – the Dr. may not even be aware.

Write the doctor, don’t visit. The letter is always in the file, can be referred to anytime, can be shared with anyone, and is proof of the communication. Certify.

Keep it factual, to the point, and focused on your objective. No complaints or emotions – that gets everyone off the point. If you want to complain, wait ‘till the billing problem is resolved. Provide a supporting doc if possible,

Dear Dr xxx

I visited your office on xx/xx/xx. Copay was rendered at the moment of service, charged to my card and payment was processed on xx/xx/xx. Attached is photocopy of credit card statement attesting to payment.

Your subsequent and continued requests for payments indicate your records are in error and need immediate correction. This has been discussed with and conformed by your billing dept on more than one occasion, but to date the promised corrections have not taken place.

Please update your records to reflect my payment on the date of service and instruct your billing dept to stop sending overdue notices or threatening collection services.

If you require any additional information I can reached ..blah blah

Regards
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Old 05-19-2009, 08:27 AM   #10
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This happened to me many times.

It tends to frustrate you, making you feel hopeless and works you into a frenzy.

Ok, stay cool, write a simple letter, attached copy of receipt, and copy of credit card statement, call Docs office, find out who is in charge of this, and send to that person's attention.

If it goes to collection, stay cool. Each collection letter will tell you that if you wish to dispute this charge or have proof that this debt is not legit, you have 30/60 days to tell us why. Again, send the same stuff to them, via cert mail.

Eventually it will clear up.

If not, then it just goes to show, no one is paying attention, they are watching Oprah.
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Old 05-19-2009, 08:28 AM   #11
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Originally Posted by FIREdreamer View Post
Hi Cool,

I was actually thinking about adding the following sentence at the end of the letter:

" Should your billing department persist in sending reminders for this bill or send this bill to collections, I will be forced to report the matter to the office of the Attorney General for the State of Alabama and other competent authorities."

But I felt that the warning was a bit too stern and antagonistic... What do you think?
Something like this just stresses me out. I've been through this a few times and had the offices tell me that their threatening letter is a form letter and is computer generated, etc. When I'd had enough I went to the main office and spoke to the person in charge, be it the office manager, doctor, president, etc. Bring all the letters, notes you made, people contacted, dates and your proof of payment. Let them know you are tired of their BS and want it stopped. Take the time to do it in person. It's too important to your peace of mind. In the future, get a steno book and keep track of your conversations of this nature. I have a dozen pages of just phone calls to Verizon, just one of many companies that make all these promises and never deliver. Get their customer service ID number if possible.
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Old 05-19-2009, 09:54 AM   #12
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Quite common, especially if the doctor is using a third party billing office, which they likely are. If the billing office has lost their copy of the record of payment (or possibly applied it to another patient's account) they are going to persist. There probably are very few people in a billing office with the authority to "fix" this. I have had a few cases similar to this over the years.

I suggest writing to the billing office manager with copy to the doctor, explain what happened, include a copy of your receipt, tell them if you owe money you will pay, then explain that your payments are current and you do not owe money. Ask for written confirmation of any action they take; you may or may not get it. Whatever you do, do not threaten action in any way at this point because if you do you can't expect to get any cooperation from them. A threat might temp them to just send you into collections just to be rid of the problem. Be businesslike. Use certified mail with return receipt. If the letter gets no response, then you can escalate.
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Old 05-19-2009, 11:48 AM   #13
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Thanks for all the good suggestions. I think I will go with a very matter-of-factly certified letter (with a copy of receipt and credit card statement attached), similar to what MichealB suggested. I will avoid being antagonistic for the time being, and hope that they take corrective actions without further prodding on my part. I will cc the doctor just in case. I will request a copy of DW's account showing a $0 balance to make sure that they made the necessary adjustment.

If the letter doesn't get the job done, I will go there in person and take it up another notch.
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Old 05-19-2009, 02:49 PM   #14
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Just an opinion but I would really work hard with the billing office. Go in person, whatever. If it goes to collection while you are waiting for the redtape to grind through it won't matter if you paid it or not. By that time you could get a letter of explanation entered on your credit reports, but the fact that the collection was begun will be there anyway. The damage is done. Been there, done that. These matters are really serious when they reach the point where you are at. Mainly because of all the time that has passed.
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Old 05-19-2009, 04:10 PM   #15
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This is a perfect example why health care reform is badly needed. The fact that a doctors office billing department can ruin a persons credit, thus making their life possibly far more difficult and expensive in the future, over $125 claim that has been paid is insanity at best.
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Old 05-21-2009, 05:29 AM   #16
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Even though you are in the right and it will eventually turn out OK i'd be concerned that this misunderstanding doesnt reach the credit people and somehow negatively affect any future credit(FICO score?).
Wonder what would have happened had you thrown out that credit card receipt assuming the service was bought and paid for.
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Old 05-21-2009, 09:44 AM   #17
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....a doctors office billing department can ruin a persons credit, thus making their life possibly far more difficult....
....causing the blood pressure to shoot up, causing..... Add that to white coat syndrome and they have a steady customer.
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Old 05-21-2009, 10:32 AM   #18
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Even though you are in the right and it will eventually turn out OK i'd be concerned that this misunderstanding doesnt reach the credit people and somehow negatively affect any future credit(FICO score?).
Wonder what would have happened had you thrown out that credit card receipt assuming the service was bought and paid for.
I have sent the certified letters yesterday (one to the billing department and one directly to the doctor). I'm sure I'll hear something soon.

I hope that the problem is resolved before it has a chance to affect my wife's credit rating. If not, these people will discover that I am no push over. If they ruin our credit, I'll ruin their reputation. In the mean time, we will start monitoring DW's credit report more closely.

I usually keep my credit card receipts until I get the monthly statement showing that the transaction went through without a hitch. Then the statement is scanned and archived indefinitely. But I still keep the paper statements for 5 years for tax purposes.
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Old 05-21-2009, 11:06 AM   #19
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I have sent the certified letters yesterday (one to the billing department and one directly to the doctor). I'm sure I'll hear something soon.

I hope that the problem is resolved before it has a chance to affect my wife's credit rating. If not, these people will discover that I am no push over. If they ruin our credit, I'll ruin their reputation. In the mean time, we will start monitoring DW's credit report more closely.

I usually keep my credit card receipts until I get the monthly statement showing that the transaction went through without a hitch. Then the statement is scanned and archived indefinitely. But I still keep the paper statements for 5 years for tax purposes.
Credit record problems are not common in situations like this because there are so many issues with medical billing. Some Doctor's billing agencies also form their own "collection agency" which is really just a title intended to motivate late payers. I have had this kind of thing go on for up to 6 months.

If you don't have a response in 2 weeks I would send another letter, still polite, asking for a response. Direct office visits are less effective because they are "undocumented" and lead to "I said - they said" debates. Having hard documentation to refer to usually leads to faster and more effective complaint resolution. Between statements and letters you are well documented and only need patience and perseverance to deal with thinkheadedness and poorly set up processes.
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Old 05-21-2009, 11:09 AM   #20
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Interesting - I would let definitely let the doctor know because this is not good business for him for his outsourced billing company to be harassing his good customers. And, as others have noted, the fact that a collections agency gets involved immediately affects your credit - and getting the collections agencies off your back is almost impossible.

I had an issue with Verizon YEARS ago and ended up complaining to the FCC about their tactics. Turns out I wasn't the only one - thank goodness Verizon hadn't gotten any of my money!

Good luck and let us know what happened.
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