Dealing with medical OC's, CA's and CRA's

[shado]

This is an overview of Why Chat's HIPAA letter process in dealing with medical OC's, CA's and CRA's.

 

I would recommend fully reading Why Chat's HIPAA page before sending any letters out.

http://whychat.5u.com/hipltr.html

 

Be sure to opt out and to update your personal information with the CRA's before doing any credit repair.

 

If using the HIPAA letters, do not have any contact with the CA(s)

 

If you have already contacted the CA with a DV or anything OTHER than a PAYMENT, you may still use the HIPAA letter program, however you must STOP responding to ANY CA communication. If you have PAID the CA, you can NOT use the HIPAA letter program.

 

If you have a CA listing on your reports, send the CRA Pre-HIPAA Letter Medical Dispute to the CRA's concerning the CA's TL. It is located at the very bottom of the HIPAA page

 

If this was to be paid by insurance and was not:

 

You should contact the insurance company to find out if or when the medical provider submitted the bill.

If they had submitted their bill in a timely manner, correctly etc.

If they had not been paid, why.

If it was denied because of the doctors office screw up, ask the insurance companies if the medical provider can refile for insurance payment.

 

Request the insurance companies send you, in writing, the reason it was not paid and if they will or will not allow the medical provider to re-file.

 

I would recommend writing to the medical provider and requesting a "full" accounting of your account. Also, request the date they had submitted the bill to the insurance company, and if it was denied, the reason the insurance gave them. Request a copy of the denial letter that the medical provider recieved from the insurance company.

 

If the OC health care provider tells you to contact the CA, DO NOT DO SO, follow the HIPAA letter program

 

The HIPAA letter program is not applicable if the account is valid and you are unable to pay it.

 

It will only work if the claim is either inaccurate, or you remit the valid correct amount due with the letter

 

If the debt is valid and you had no insurance at the time of service, or it is from the deductible from your insurance:

 

Send the HIPAA letter using [insert a ] along with your payment.

 

If you had insurance and the medical provider failed to submit a bill to insurance in a timely or correct manner, and the insurance provider will not allow the medical provider to re-file. Or is from a billing error:

 

Send the HIPAA letter using [insert b ]

 

If is not your account:

 

Send the HIPAA letter using [insert c ]

 

 

I strongly recommend that you follow all of the steps Why Chat has listed, and also, be sure to utilize all of the follow-up letters.

 

If you follow ALL the program letters and procedures and you are unable to resolve the problem, you then must file a complaint with the OCR on the HIPAA violations. If you must do so, follow ALL the directions and include copies of ALL your documentation including the "courtesy letter".*

 

Again - This is just an overview. Please read Why Chat's HIPAA page thoroughly before sending any letters.

 

If you have any questions, please post do not post them on this thread. Post them in the Medical Billing & Medical Collections - Forum Topics

 

 

*Why Chat will be adding a "sample" of a "courtesy letter".