CA claims THEY will bill insurance with correct info

[kkaple]

Good evening, everyone. Okay, I just started working on BIL's CR and he has (ghast!) one unpaid medical collection for $1X0 from United Collection Bureau (or something of the like).

 

Here's the scenarion: he had an ER visit back in early spring. He is a college student and thought that his parents' insurance would cover the visit. Evidently, dad had changed insurance carriers and had not yet given BIL an updated card. Old insurance did not cover the visit, but since he had new insurance coverage at the time, just the wrong card, the new insurance will.

 

Fast forward now about ten months. The hospital has farmed the whole balance out to the state AG's office (who is billing his insurance and is NOT on his CR) and the remaining $1X0 (the doctor's bill) to this CA. BIL finally gets back to dad about who's paying what and BIL also calls the CA to find out what to do (duh).

 

The CA tells him, just send us your insurance information and WE will bill the insurance. It is out of the hospital's hands.

 

This sounds odd to me. I've been reading the boards for over a year and haven't heard anything quite like this. I told BIL that the objective is to get the bill paid by new insurance AND to get this removed from the CR. I was thinking of (maybe) the HIPAA series to the hospital? I'm just at a loss of how to handle this. Why would the CA be billing the insurance? Would a PFD be in order with the insurance information?

 

Thanks for the help on this one. I appreciate any and all of your advice. I'd like to get a gameplan back to him by tomorrow evening. We haven't even touched this one to dispute it, DV it, or anything else because I'm not quite sure where to start and what the best course of action would be.

 

Kris

Edited January 11, 2006 by kkaple

[shado]

Has the carrier of the "new" insurance been contacted yet to see if they will still pay the hospital? If they haven't been contacted yet, your BIL may want to contact them as soon as possible. If to much time passes, they may not cover it.

 

Don't talk or write to the CA again.

 

I would suggest first - contact the insurance company and see if they will pay. Since it has been awhile from when the debt was incurred, they may not pay.

 

If they say that they will pay, maybe go talk to the hospital billing and ask them to pull the account back from the CA and file with the insurance. (I'm not 100% sure on this step, hoping Why Chat will be in and suggest on this)

 

I don't think you can use the HIPAA to get the hospital to file with insurance.

 

If the insurance company refuses to pay due to the time since service, and you had mentioned your BIL may pay it, use the HIPAA letter with (insert a ) and pay the hospital NOT the CA.

 

When using HIPAA, you do not want to have any contact at all with the CA.

 

If you haven't been to Why Chat's site yet and read the HIPAA page, I would strongly recommend it. Read the whole page and when using HIPAA, be sure to follow all of the steps and use all of the followup letters.

 

http://whychat.5u.com/

[kkaple]

Thank you for your advice. I have studied the HIPAA series before and I thought that it may be a viable option. I just needed someone to help me to sort through it, I guess.

 

What I will do then is have BIL contact the insurance and the hospital to try to resolve it that way. If the insurance will not pay, then we'll use the HIPAA series through the hospital.

 

Here's my next question, I guess: What if the insurance agrees to pay, but the hospital refuses to re-bill them and pull it back from collections?

 

Hopefully, WhyChat has some advice here for me (please).

 

Kris

[cotterpin]

Send the insurance the bill yourself

 

It IS uncommon but not unheard of. Some providers do have a policy of completely turning over the accounts after X amount of days and allowing the CA to complete all aspects, including insurance billing. There are CA's for medical that specialize in this type of recievable management.

[kkaple]

Send the insurance the bill yourself

 

It IS uncommon but not unheard of. Some providers do have a policy of completely turning over the accounts after X amount of days and allowing the CA to complete all aspects, including insurance billing. There are CA's for medical that specialize in this type of recievable management.

 

 

Okay, kind of a dumb question here, but should I send the insurance the bill from the hospital or the bill from the CA? Or, should I just try to have the hospital resubmit the bill to insurance first?

 

Thanks.

 

Kris

[cotterpin]

If you can get it, the hospital bill is best to use.

[kkaple]

Okay, so call the hospital and request the bill...then call the insurance to find out where to send the claim? And then, how do we get the account deleted through the CA? I just want to make sure that I'm following the sequences right. Thanks!

 

Kris

Edited January 13, 2006 by kkaple

[shado]

If you send the bill to the insurance and they are still willing to pay the bill, wait until after the bill is paid then send the CRA medical dispute letter concerning the CA. (it's at the very bottom of the HIPAA page on Why Chat's site)

[kkaple]

Thank you...I appreciate the input. BIL is calling the hospital today to request that they bill the insurance again and if not, just send us a copy of the bill. Then, we'll send that HIPAA letter to the CRAs in a few weeks.

 

Even though I've been a pretty active CB member for a year, I still need help and I appreciate your replies. Thanks!

 

Kris

[shado]

Thank you...I appreciate the input. BIL is calling the hospital today to request that they bill the insurance again and if not, just send us a copy of the bill. Then, we'll send that HIPAA letter to the CRAs in a few weeks.

 

Even though I've been a pretty active CB member for a year, I still need help and I appreciate your replies. Thanks!

 

Kris

Wishing your BIL good luck with getting the insurance to pay. I know it will be a relief to get something like that behind him.

 

Be sure that the bill has been paid before sending the letter to the CRA's. Keep in contact with the insurance company and/or the hospital and keep an eye on the credit reports. "Hopefully", when the hospital gets paid, they will recall the debt from the CA and insure the CA removes the TL and you won't even have to mess with sending a letter.

 

I know what you mean about being an active member but still needing help.

 

There is so much information on CB and Why Chat's site that it can overwhelming. So, I generally just concentrate on what I am dealing with and when something new pops up I may have to ask some questions if I have trouble finding answers.

 

I'm just glad there are so many smart people on CB (and no, I'm not naming any names cause I don't want to be accused of sucking up again )