Getting dunned by CA, would not validate.

[FHGHGA]

Okay, I was getting collection letters for a medical bill I did not know about, they entered it on my credit as well. The bill was for a bit over 1000.00, it was purchased from another collection agency that sent me a letter for 900.00....so right there was 100.00 added.

 

So I contacted the OC/Hospital for a billing statement for date of service and information about the bill, since I didn't recall anything this much for my daughter and the CA wouldn't validate anything, but instead kept selling it.

 

So now the OC sends me a bill showing a breakdown of all the charges and shows our insurance on file but doesn't show any type of credit/payment and wants over 4000.00!!!!

 

I looked up my insurance EOB and it just says allowance of almost 3300.00......is this a payment or does the hospital not recognize this as a credit and I'm still held for the full amount?

 

Thanks!!!

[FHGHGA]

Anyone? I would appreciate any help you can offer....I suppose maybe I should just write a letter to the hospital in response to their billing statement and ask if the insurance paid anything, as the collection agency was only dunning me for a bit over 1000.00.

 

Thanks again!!!!

[The Zoo]

Have you contacted your insurance carrier to see what they paid? Stay away from the CA's. You need to find out if you actually owe anything. It would be best if your carrier could send you a copy an itemized statement that shows what they paid, what your deductible should have been and what amounts, if any, were considered disallowed by the carrier.

[FHGHGA]

Have you contacted your insurance carrier to see what they paid?  Stay away from the CA's.  You need to find out if you actually owe anything.  It would be best if your carrier could send you a copy an itemized statement that shows what they paid, what your deductible should have been and what amounts, if any, were considered disallowed by the carrier.

<{POST_SNAPBACK}>

 

Phoned my insurance from that time, this morning when they opened their office. The nice insurance rep said that they allowed just a tad over 900.00 applied to my deductible. So I'm liable for that amount per our conversation. She told me that just about every line of the claim had some note for further information needed to fully process the claim and that I needed to convey that to the hospital.

 

I ended up phoning the hospital to tell them that the insurance would and could pay more if they would supply the additional information and she said it wasn't noted that the insurance needed more information, even though I told her what I was told just minutes before. She said they wrote off the remaining balance per their contractual agreement.....whatever!!

 

She then told me that if I wanted to work out payments I'd have to contact the CA, or pay the OC in full. She said the additional 100.00 was the collection fees, and not sure why the hospital sent me a bill for 4000.00+. She wasn't very nice, and so I'm going back to letter writing.

 

I'll send them a letter asking for deletion from the CA and my CR for payment of my porting in full. Or if I get brave I might try and settle since the claim is over 2 years old.

[cotterpin]

If they wrote off the amounts over the insurance allowable, why are they billing you for it?

[The Zoo]

I'm still think you need that original billing information sheet from the insurance company. And as Cotter asked: Why are they billing you for items written off over what the insurance company allowed?

[FHGHGA]

I'm still think you need that original billing information sheet from the insurance company.  And as Cotter asked:  Why are they billing you for items written off over what the insurance company allowed?

<{POST_SNAPBACK}>

 

The hospital is billing me for the allowed amount by the insurance company. The CA is billing me for that amount plus the collection fee of 100+. The hospital sent me a complete and detailed charge/bill statement showing all the medicine used, the procedures....etc but failed to include any sort of entry where they show what they wrote off, and what the bottom line was that I owed.

 

Not sure why they did it that way, but I'm writing them a letter asking for a complete account of my bill with an accurate total amount due and that I can pay in full to them when they pull it from the CA.

[The Zoo]

I know I'm starting to sound like a broken record, but if any of this amount was "disallowed" by the insurance company (in other words, they charged more than they should have) you should not be responsible for that amount. You should only be responsible for the Deductible Amount set in the contract between you and your insurance carrier. You need to know for certain from the insurance carrier that none of this amount is "disallowed" by the carrier. And I agree that you should have an itemized statement from the hospital to make sure they aren't billing you for anything they didn't do.

[cotterpin]

A complete accounting is one of the most important things you need.

 

Also, they can only charge you the collection fee if it was spelled out in the original agreement that you would pay this

[FHGHGA]

I know I'm starting to sound like a broken record, but if any of this amount was "disallowed" by the insurance company (in other words, they charged more than they should have) you should not be responsible for that amount.  You should only be responsible for the Deductible Amount set in the contract between you and your insurance carrier. 

<{POST_SNAPBACK}>

 

That is what they are billing me for. They are billing me for 900.00 which is the allowed amount per the insurance. They disallowed 3100.00, which the hospital wrote off. I am still getting a full accounting though, just so I'll have it for my records.

 

Thanks again for the explanation and help