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Pre-HIPAA backfired, now what? HELP!


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35 replies to this topic

#1 thankfulheart

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Posted 18 November 2011 - 08:23 PM

I did all the steps, opted out, changed addresses, hand wrote the pre-HIPAAs. In today's mail, I get a collection notice from a medical CA along with 4 pages of highlighted amounts totalling $1120. They have my daughter's name and many of them are "insurance denied" for whatever reason. The bills were incurred in Ohio, with a 15 year SOL on "written contracts" (I'm just guessing that's what a medical bill is). I currently live in FL with a 4 year SOL on "written contracts". The DOFDs appear to be 7/05, 9/06, 8/07, 5/08, and 12/10.

Any documents I have relating to medical insurance during that time are no longer available to me (back in Ohio, long story).

I had this CA down to 2 entries on my CR. Now that they have "validated", is it all going to show up again? And, what are my next steps? Which SOL applies?

Please help.



#2 Why Chat

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Posted 19 November 2011 - 06:33 AM

I did all the steps, opted out, changed addresses, hand wrote the pre-HIPAAs. In today's mail, I get a collection notice from a medical CA along with 4 pages of highlighted amounts totalling $1120. They have my daughter's name and many of them are "insurance denied" for whatever reason. The bills were incurred in Ohio, with a 15 year SOL on "written contracts" (I'm just guessing that's what a medical bill is). I currently live in FL with a 4 year SOL on "written contracts". The DOFDs appear to be 7/05, 9/06, 8/07, 5/08, and 12/10.

Any documents I have relating to medical insurance during that time are no longer available to me (back in Ohio, long story).

I had this CA down to 2 entries on my CR. Now that they have "validated", is it all going to show up again? And, what are my next steps? Which SOL applies?

Please help.

This is NOT a "backfire", nor is it "validation" A medical bill has a 4 year SOL for being sued in ALL States.
How old was your daughter when these charges were incurred??
Was she on your insurance??

If you you do not have copies of the EOMB's ( explanation of medical benefits) from your
Contact the insurance Co. and get copies of all your EOMBs for these accounts.

#3 thankfulheart

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Posted 19 November 2011 - 08:25 AM

This is NOT a "backfire", nor is it "validation" A medical bill has a 4 year SOL for being sued in ALL States.
How old was your daughter when these charges were incurred??
Was she on your insurance??

If you you do not have copies of the EOMB's ( explanation of medical benefits) from your
Contact the insurance Co. and get copies of all your EOMBs for these accounts.


Thank you for your reassurance that I am overreacting! I'm afraid I was a bit taken aback by it and freaked out. I appreciate the voice of reason and calm.

My daughter was 8 at the first DOS and 13 at the last. I do not have EOBs, so will attempt to contact the insurance companies for copies of them (there are 3 insurance co involved).

I know I'm not supposed to communicate with the CA, but will this resurface on my CRA? I haven't gotten a response from the actual CRA/pre-HIPAA letters I sent, but it's only been 2 weeks, so wasn't looking for anything just yet.

#4 Why Chat

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Posted 19 November 2011 - 09:17 AM



This is NOT a "backfire", nor is it "validation" A medical bill has a 4 year SOL for being sued in ALL States.
How old was your daughter when these charges were incurred??
Was she on your insurance??

If you you do not have copies of the EOMB's ( explanation of medical benefits) from your
Contact the insurance Co. and get copies of all your EOMBs for these accounts.


Thank you for your reassurance that I am overreacting! I'm afraid I was a bit taken aback by it and freaked out. I appreciate the voice of reason and calm.

My daughter was 8 at the first DOS and 13 at the last. I do not have EOBs, so will attempt to contact the insurance companies for copies of them (there are 3 insurance co involved).

I know I'm not supposed to communicate with the CA, but will this resurface on my CRA? I haven't gotten a response from the actual CRA/pre-HIPAA letters I sent, but it's only been 2 weeks, so wasn't looking for anything just yet.

If you received this response from the reporting CA it was in response to your dispute.

Did you delete old addresses from your reports AFTER you opted out??

Wait for a response from the CRAs and THEN post here as to what has occurred.

#5 thankfulheart

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Posted 21 November 2011 - 01:04 AM

[If you received this response from the reporting CA it was in response to your dispute.

Did you delete old addresses from your reports AFTER you opted out??

Wait for a response from the CRAs and THEN post here as to what has occurred.


I did change addresses after opting out.

Question in the interim...the CA on the CRA at TU shows a lump sum of the '05-'08 accounts and the '10 one is a separate line. How will the 7 year thing play into reporting that?

#6 Why Chat

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Posted 21 November 2011 - 05:53 PM


[If you received this response from the reporting CA it was in response to your dispute.

Did you delete old addresses from your reports AFTER you opted out??

Wait for a response from the CRAs and THEN post here as to what has occurred.


I did change addresses after opting out.

Question in the interim...the CA on the CRA at TU shows a lump sum of the '05-'08 accounts and the '10 one is a separate line. How will the 7 year thing play into reporting that?

I don't know. It is POSSIBLE that the latest bill can be verified to the CRAs. It is possible that they can't verify ANY of the accounts. It is possible that you may have to pay the OC ( Hospital??) the correct amount that you actually owe ( based on your EOMBs) with the HIPAA letter insert "a", or you may have to send the OC the HIPAA letter insert "b" if the EOMBs indicate there is nothing owed, or you may have to do a combination of "a" and "b" if you owe on 1 or more accounts and nothing on the others.
http://www.whychat.5u.com/hipltr.html

It is also possible that you will obtain a complete deletion of all the accounts you disputed from all the CRAs.

If you are worried about any reinsertion, I hope you have the letters from the CRAs when you got rid of the accounts that were deleted.

Edited by Why Chat, 21 November 2011 - 05:56 PM.


#7 thankfulheart

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Posted 26 November 2011 - 06:32 PM

Experian sent me a form letter that didn't have any results in it at all, just that I "may want to contact the furnisher of information directly..." blah, blah, blah. Since I requested it, shouldn't they have sent an updated copy of my CR? also, shouldn't they have sent me the information I specifically requested in the pre-HIPAA letter (names, addresses, etc?)

I pulled it online and discovered that they have removed all but one of the medical collections and it is still showing "disputed by consumer". I'm still waiting for a response from EQ on this same account, so once I get that, I guess I will proceed to the DV steps, yes?

I have one more on EQ and 2 on TU, although I called them last week to sort something out and they told me that one was deleted, (but it's still showing up on my USAA daily pulls?) and the other was still being "investigated".

I have been keeping all of the letters and printing up the updated reports for my files to counter re-insertion if it happens.

#8 Why Chat

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Posted 27 November 2011 - 03:47 PM

Experian sent me a form letter that didn't have any results in it at all, just that I "may want to contact the furnisher of information directly..." blah, blah, blah. Since I requested it, shouldn't they have sent an updated copy of my CR? also, shouldn't they have sent me the information I specifically requested in the pre-HIPAA letter (names, addresses, etc?)

I pulled it online and discovered that they have removed all but one of the medical collections and it is still showing "disputed by consumer". I'm still waiting for a response from EQ on this same account, so once I get that, I guess I will proceed to the DV steps, yes?

I have one more on EQ and 2 on TU, although I called them last week to sort something out and they told me that one was deleted, (but it's still showing up on my USAA daily pulls?) and the other was still being "investigated".

I have been keeping all of the letters and printing up the updated reports for my files to counter re-insertion if it happens.

When you called them "to sort something out" you added 15 days to the time they had to answer your dispute.

#9 thankfulheart

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Posted 28 November 2011 - 01:37 AM


Experian sent me a form letter that didn't have any results in it at all, just that I "may want to contact the furnisher of information directly..." blah, blah, blah. Since I requested it, shouldn't they have sent an updated copy of my CR? also, shouldn't they have sent me the information I specifically requested in the pre-HIPAA letter (names, addresses, etc?)

I pulled it online and discovered that they have removed all but one of the medical collections and it is still showing "disputed by consumer". I'm still waiting for a response from EQ on this same account, so once I get that, I guess I will proceed to the DV steps, yes?

I have one more on EQ and 2 on TU, although I called them last week to sort something out and they told me that one was deleted, (but it's still showing up on my USAA daily pulls?) and the other was still being "investigated".

I have been keeping all of the letters and printing up the updated reports for my files to counter re-insertion if it happens.

When you called them "to sort something out" you added 15 days to the time they had to answer your dispute.


Even though it was for a completely different thing (student loan) w/ TU? Shouldn't EX have sent me the name/address/etc that I requested in the pre-HIPAA if they had indeed confirmed the debt? And, shouldn't they have sent me an updated copy of my report? The letter had zero information about what had been disputed, just that I should ocntact the furnisher of the information. There was NOTHING about what had been validated or removed or anything.

#10 ashlia

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Posted 28 November 2011 - 10:20 AM



Experian sent me a form letter that didn't have any results in it at all, just that I "may want to contact the furnisher of information directly..." blah, blah, blah. Since I requested it, shouldn't they have sent an updated copy of my CR? also, shouldn't they have sent me the information I specifically requested in the pre-HIPAA letter (names, addresses, etc?)

I pulled it online and discovered that they have removed all but one of the medical collections and it is still showing "disputed by consumer". I'm still waiting for a response from EQ on this same account, so once I get that, I guess I will proceed to the DV steps, yes?

I have one more on EQ and 2 on TU, although I called them last week to sort something out and they told me that one was deleted, (but it's still showing up on my USAA daily pulls?) and the other was still being "investigated".

I have been keeping all of the letters and printing up the updated reports for my files to counter re-insertion if it happens.

When you called them "to sort something out" you added 15 days to the time they had to answer your dispute.


Even though it was for a completely different thing (student loan) w/ TU? Shouldn't EX have sent me the name/address/etc that I requested in the pre-HIPAA if they had indeed confirmed the debt? And, shouldn't they have sent me an updated copy of my report? The letter had zero information about what had been disputed, just that I should ocntact the furnisher of the information. There was NOTHING about what had been validated or removed or anything.


Yes.

#11 Why Chat

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Posted 28 November 2011 - 11:08 AM



Experian sent me a form letter that didn't have any results in it at all, just that I "may want to contact the furnisher of information directly..." blah, blah, blah. Since I requested it, shouldn't they have sent an updated copy of my CR? also, shouldn't they have sent me the information I specifically requested in the pre-HIPAA letter (names, addresses, etc?)

I pulled it online and discovered that they have removed all but one of the medical collections and it is still showing "disputed by consumer". I'm still waiting for a response from EQ on this same account, so once I get that, I guess I will proceed to the DV steps, yes?

I have one more on EQ and 2 on TU, although I called them last week to sort something out and they told me that one was deleted, (but it's still showing up on my USAA daily pulls?) and the other was still being "investigated".

I have been keeping all of the letters and printing up the updated reports for my files to counter re-insertion if it happens.

When you called them "to sort something out" you added 15 days to the time they had to answer your dispute.


Even though it was for a completely different thing (student loan) w/ TU? Shouldn't EX have sent me the name/address/etc that I requested in the pre-HIPAA if they had indeed confirmed the debt? And, shouldn't they have sent me an updated copy of my report? The letter had zero information about what had been disputed, just that I should ocntact the furnisher of the information. There was NOTHING about what had been validated or removed or anything.

It doesn't matter what you inquired about, and NO, "ashlia" is mistaken. The CRA's are under NO obligation to do anything other than respond to your dispute within 30 days on a "paid" report, 45 days on a "free" report, and they are allowed to add 15 days to that response for ANY inquiry on your report.

#12 thankfulheart

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Posted 26 December 2011 - 03:48 AM

I waited patiently for the dispute results. I am now down to 1 med collection for $100 that shows on both EX and EQ. I received a letter from the CA and will continue the HIPAA process on that one. I have another on EQ for $175 and one on TU for $733, both from the same CA that originally sent me the 4 pages totalling $1120. I don't know how to proceed with that CA. They are lumping several visits over a few years and from different providers into a single amount. Can they do that? Seems that messes with DOFD?

I've been unsuccessful at getting EOBs so far.

#13 thankfulheart

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Posted 04 January 2012 - 11:43 PM

Bumping...I'm confused on the lumping all together thing...

Can the CA lump together a bunch of individual charges into a lump sum? I have tried and tried with the pages of numbers they sent me, but NONE of it adds up to the $733 they say I owe.

I did send the CA the next step in the HIPAA process, so am still waiting on their reply, I'm just wondering about the legality of what they've done with the numbers.

#14 breeze

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Posted 05 January 2012 - 12:09 AM

No, for some reason they think it's ok to merge accounts, I had one split an account, first into 4 payments, which became 4 accounts. Chalk it up to incompetence, but no, if it changes the date on the account, just get your own records from the insurance company, and work from them. Ignore the CA, they want you to get all upset and think you have to do this on their terms.

#15 thankfulheart

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Posted 07 January 2012 - 03:42 AM

I waited patiently for the dispute results. I am now down to 1 med collection for $100 that shows on both EX and EQ. I received a letter from the CA and will continue the HIPAA process on that one. I have another on EQ for $175 and one on TU for $733, both from the same CA that originally sent me the 4 pages totalling $1120. I don't know how to proceed with that CA. They are lumping several visits over a few years and from different providers into a single amount. Can they do that? Seems that messes with DOFD?

I've been unsuccessful at getting EOBs so far.



In my recent research and packing up my 2011 files, I found the EOB for the $175 indicating that it had been PIF by the insurance company. I sent that on with a HIPAA letter to the OC. I'm still waiting on the responses to the other 2 HIPAAs for the remaining 2 CAs. I'm still stumped over the $733, though. Cannot figure that math out AT ALL from what they sent. I just want it OFF.

#16 thankfulheart

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Posted 01 February 2012 - 03:22 AM


I waited patiently for the dispute results. I am now down to 1 med collection for $100 that shows on both EX and EQ. I received a letter from the CA and will continue the HIPAA process on that one. I have another on EQ for $175 and one on TU for $733, both from the same CA that originally sent me the 4 pages totalling $1120. I don't know how to proceed with that CA. They are lumping several visits over a few years and from different providers into a single amount. Can they do that? Seems that messes with DOFD?

I've been unsuccessful at getting EOBs so far.



In my recent research and packing up my 2011 files, I found the EOB for the $175 indicating that it had been PIF by the insurance company. I sent that on with a HIPAA letter to the OC. I'm still waiting on the responses to the other 2 HIPAAs for the remaining 2 CAs. I'm still stumped over the $733, though. Cannot figure that math out AT ALL from what they sent. I just want it OFF.



Bumping this as I'm coming up on 30 days with no response from any of them. Next step is to send the CRAs the letter requesting reinvestigation, yes?

#17 Why Chat

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Posted 01 February 2012 - 10:46 AM



I waited patiently for the dispute results. I am now down to 1 med collection for $100 that shows on both EX and EQ. I received a letter from the CA and will continue the HIPAA process on that one. I have another on EQ for $175 and one on TU for $733, both from the same CA that originally sent me the 4 pages totalling $1120. I don't know how to proceed with that CA. They are lumping several visits over a few years and from different providers into a single amount. Can they do that? Seems that messes with DOFD?

I've been unsuccessful at getting EOBs so far.



In my recent research and packing up my 2011 files, I found the EOB for the $175 indicating that it had been PIF by the insurance company. I sent that on with a HIPAA letter to the OC. I'm still waiting on the responses to the other 2 HIPAAs for the remaining 2 CAs. I'm still stumped over the $733, though. Cannot figure that math out AT ALL from what they sent. I just want it OFF.



Bumping this as I'm coming up on 30 days with no response from any of them. Next step is to send the CRAs the letter requesting reinvestigation, yes?

Had you already sent the HIPAA letter insert "b" with the copy of the EOMB to the OC??

#18 thankfulheart

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Posted 01 February 2012 - 03:26 PM




I waited patiently for the dispute results. I am now down to 1 med collection for $100 that shows on both EX and EQ. I received a letter from the CA and will continue the HIPAA process on that one. I have another on EQ for $175 and one on TU for $733, both from the same CA that originally sent me the 4 pages totalling $1120. I don't know how to proceed with that CA. They are lumping several visits over a few years and from different providers into a single amount. Can they do that? Seems that messes with DOFD?

I've been unsuccessful at getting EOBs so far.



In my recent research and packing up my 2011 files, I found the EOB for the $175 indicating that it had been PIF by the insurance company. I sent that on with a HIPAA letter to the OC. I'm still waiting on the responses to the other 2 HIPAAs for the remaining 2 CAs. I'm still stumped over the $733, though. Cannot figure that math out AT ALL from what they sent. I just want it OFF.



Bumping this as I'm coming up on 30 days with no response from any of them. Next step is to send the CRAs the letter requesting reinvestigation, yes?

Had you already sent the HIPAA letter insert "b" with the copy of the EOMB to the OC??



Yes, for the one for which I had the EOB got the insert "b" to the OC. The other 2 were the "Letter to CA on Medical Account Reporting With a Balance Due" (this was done after my initial HIPAA to the CRAs and they "updated" with the items still reporting). The EOB one gets the "reinvestigate" letter to the CRA while the other 2 get the CRA "no valid response" dispute all CMRR, yes?

#19 Why Chat

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Posted 01 February 2012 - 05:39 PM





I waited patiently for the dispute results. I am now down to 1 med collection for $100 that shows on both EX and EQ. I received a letter from the CA and will continue the HIPAA process on that one. I have another on EQ for $175 and one on TU for $733, both from the same CA that originally sent me the 4 pages totalling $1120. I don't know how to proceed with that CA. They are lumping several visits over a few years and from different providers into a single amount. Can they do that? Seems that messes with DOFD?

I've been unsuccessful at getting EOBs so far.



In my recent research and packing up my 2011 files, I found the EOB for the $175 indicating that it had been PIF by the insurance company. I sent that on with a HIPAA letter to the OC. I'm still waiting on the responses to the other 2 HIPAAs for the remaining 2 CAs. I'm still stumped over the $733, though. Cannot figure that math out AT ALL from what they sent. I just want it OFF.



Bumping this as I'm coming up on 30 days with no response from any of them. Next step is to send the CRAs the letter requesting reinvestigation, yes?

Had you already sent the HIPAA letter insert "b" with the copy of the EOMB to the OC??



Yes, for the one for which I had the EOB got the insert "b" to the OC. The other 2 were the "Letter to CA on Medical Account Reporting With a Balance Due" (this was done after my initial HIPAA to the CRAs and they "updated" with the items still reporting). The EOB one gets the "reinvestigate" letter to the CRA while the other 2 get the CRA "no valid response" dispute all CMRR, yes?

?? For the EOB one sent with insert "b-1" to the OC, you do the follow up letters, ( scroll down past insert "c")
For the ones that you sent the medical DV to the CAs you send the follow up dispute to the CRAs

#20 ashlia

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Posted 02 February 2012 - 01:22 PM




Experian sent me a form letter that didn't have any results in it at all, just that I "may want to contact the furnisher of information directly..." blah, blah, blah. Since I requested it, shouldn't they have sent an updated copy of my CR? also, shouldn't they have sent me the information I specifically requested in the pre-HIPAA letter (names, addresses, etc?)

I pulled it online and discovered that they have removed all but one of the medical collections and it is still showing "disputed by consumer". I'm still waiting for a response from EQ on this same account, so once I get that, I guess I will proceed to the DV steps, yes?

I have one more on EQ and 2 on TU, although I called them last week to sort something out and they told me that one was deleted, (but it's still showing up on my USAA daily pulls?) and the other was still being "investigated".

I have been keeping all of the letters and printing up the updated reports for my files to counter re-insertion if it happens.

When you called them "to sort something out" you added 15 days to the time they had to answer your dispute.


Even though it was for a completely different thing (student loan) w/ TU?
Shouldn't EX have sent me the name/address/etc that I requested in the pre-HIPAA if they had indeed confirmed the debt? And, shouldn't they have sent me an updated copy of my report? The letter had zero information about what had been disputed, just that I should ocntact the furnisher of the information. There was NOTHING about what had been validated or removed or anything.

It doesn't matter what you inquired about, and NO, "ashlia" is mistaken. The CRA's are under NO obligation to do anything other than respond to your dispute within 30 days on a "paid" report, 45 days on a "free" report, and they are allowed to add 15 days to that response for ANY inquiry on your report.


Edited by ashlia, 02 February 2012 - 01:34 PM.


#21 ashlia

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Posted 02 February 2012 - 01:24 PM




Experian sent me a form letter that didn't have any results in it at all, just that I "may want to contact the furnisher of information directly..." blah, blah, blah. Since I requested it, shouldn't they have sent an updated copy of my CR? also, shouldn't they have sent me the information I specifically requested in the pre-HIPAA letter (names, addresses, etc?)

I pulled it online and discovered that they have removed all but one of the medical collections and it is still showing "disputed by consumer". I'm still waiting for a response from EQ on this same account, so once I get that, I guess I will proceed to the DV steps, yes?

I have one more on EQ and 2 on TU, although I called them last week to sort something out and they told me that one was deleted, (but it's still showing up on my USAA daily pulls?) and the other was still being "investigated".

I have been keeping all of the letters and printing up the updated reports for my files to counter re-insertion if it happens.

When you called them "to sort something out" you added 15 days to the time they had to answer your dispute.


Even though it was for a completely different thing (student loan) w/ TU? Shouldn't EX have sent me the name/address/etc that I requested in the pre-HIPAA if they had indeed confirmed the debt? And, shouldn't they have sent me an updated copy of my report? The letter had zero information about what had been disputed, just that I should ocntact the furnisher of the information. There was NOTHING about what had been validated or removed or anything.


Yes.


I was only answering the bolded question.

#22 thankfulheart

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Posted 04 February 2012 - 06:29 PM

I am SO confused now.

I received a certified letter from the OC on the $175 (for which I had the EOB, sent the HIPAA letter with insert B and copy of the EOB). It says:

"The HIPAA law that you referenced specifically permits covered entities such as "OC" to use and disclose PHI for payment activities. Payment activities are defined to include not only billing, but also collection activities and disclosure to consumer reporting agencies. Covered entities may retain third parties, such as collection agencies, to assist in the performance of payment activities. The HIPAA law permits covered entities to share PHI with these third parties and permits these third parties to use and disclose PHI as necessary to perform functions on behalf of covered entities.

According to our records, you had two accounts placed for collection. A balance of $10.00 attributable to a co-payment, was placed with "CA" for collection. A balance of $63.00, attributable to XXX determined by "ins co" to be non-covered, was placed with "2nd CA" for collection. If you have any questions contact "X"."

Okay, well, duh on the HIPAA section. CA is reporting $175 for the bill (which did have a $10 co-pay, paid at TOS, but there is no way I have a receipt for that at this point. If it were truly $10 owed, shouldn't it be REPORTING $10? The other $63 was removed much earlier in the HIPAA process. I'll be happy to pay another $10 to get this off, but I'm still ticked at how it's reporting.

What should be the next step for this one? It's only reporting on EQ, do I go ahead with the next step of the HIPAA dispute and send a copy of the EOB showing it was paid to EQ?

#23 Why Chat

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Posted 04 February 2012 - 08:23 PM

I am SO confused now.

I received a certified letter from the OC on the $175 (for which I had the EOB, sent the HIPAA letter with insert B and copy of the EOB). It says:

"The HIPAA law that you referenced specifically permits covered entities such as "OC" to use and disclose PHI for payment activities. Payment activities are defined to include not only billing, but also collection activities and disclosure to consumer reporting agencies. Covered entities may retain third parties, such as collection agencies, to assist in the performance of payment activities. The HIPAA law permits covered entities to share PHI with these third parties and permits these third parties to use and disclose PHI as necessary to perform functions on behalf of covered entities.

According to our records, you had two accounts placed for collection. A balance of $10.00 attributable to a co-payment, was placed with "CA" for collection. A balance of $63.00, attributable to XXX determined by "ins co" to be non-covered, was placed with "2nd CA" for collection. If you have any questions contact "X"."

Okay, well, duh on the HIPAA section. CA is reporting $175 for the bill (which did have a $10 co-pay, paid at TOS, but there is no way I have a receipt for that at this point. If it were truly $10 owed, shouldn't it be REPORTING $10? The other $63 was removed much earlier in the HIPAA process. I'll be happy to pay another $10 to get this off, but I'm still ticked at how it's reporting.

What should be the next step for this one? It's only reporting on EQ, do I go ahead with the next step of the HIPAA dispute and send a copy of the EOB showing it was paid to EQ?

I am afraid I have lost track of what you have actually done.

You opted out?
You disputed old addresses?
You sent the initial dispute letter to the CRAs?
You had NOTHING deleted as a result??
You sent the medical DV to the reporting CAs?
You sent the follow up dispute to the CRAs??

If the response you cited was from the HIPAA letter insert "b" with the EOB than the next steps are posted following insert "c" on the HIPAA letter program. The letter they sent you is a standard response without any effect on the program.

Edited by Why Chat, 04 February 2012 - 08:27 PM.


#24 thankfulheart

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Posted 05 February 2012 - 03:40 AM


I am SO confused now.

I received a certified letter from the OC on the $175 (for which I had the EOB, sent the HIPAA letter with insert B and copy of the EOB). It says:

"The HIPAA law that you referenced specifically permits covered entities such as "OC" to use and disclose PHI for payment activities. Payment activities are defined to include not only billing, but also collection activities and disclosure to consumer reporting agencies. Covered entities may retain third parties, such as collection agencies, to assist in the performance of payment activities. The HIPAA law permits covered entities to share PHI with these third parties and permits these third parties to use and disclose PHI as necessary to perform functions on behalf of covered entities.

According to our records, you had two accounts placed for collection. A balance of $10.00 attributable to a co-payment, was placed with "CA" for collection. A balance of $63.00, attributable to XXX determined by "ins co" to be non-covered, was placed with "2nd CA" for collection. If you have any questions contact "X"."

Okay, well, duh on the HIPAA section. CA is reporting $175 for the bill (which did have a $10 co-pay, paid at TOS, but there is no way I have a receipt for that at this point. If it were truly $10 owed, shouldn't it be REPORTING $10? The other $63 was removed much earlier in the HIPAA process. I'll be happy to pay another $10 to get this off, but I'm still ticked at how it's reporting.

What should be the next step for this one? It's only reporting on EQ, do I go ahead with the next step of the HIPAA dispute and send a copy of the EOB showing it was paid to EQ?

I am afraid I have lost track of what you have actually done.

You opted out?
You disputed old addresses?
You sent the initial dispute letter to the CRAs?
You had NOTHING deleted as a result??
You sent the medical DV to the reporting CAs?
You sent the follow up dispute to the CRAs??

If the response you cited was from the HIPAA letter insert "b" with the EOB than the next steps are posted following insert "c" on the HIPAA letter program. The letter they sent you is a standard response without any effect on the program.


Yes, I have done all of the above in order except for the follow up dispute. In the process, several accounts were deleted, just not these final few. The follow up to CRA was the step I was on when I got this letter back from the OC. Should I go ahead and send in what they claim to be the $10 copay still owing on the one I have the EOB for and try again with insert A? I'm just trying to figure out if I owe them $10, why they are reporting it at $175.

#25 Why Chat

Why Chat
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Posted 05 February 2012 - 10:12 AM



I am SO confused now.

I received a certified letter from the OC on the $175 (for which I had the EOB, sent the HIPAA letter with insert B and copy of the EOB). It says:

"The HIPAA law that you referenced specifically permits covered entities such as "OC" to use and disclose PHI for payment activities. Payment activities are defined to include not only billing, but also collection activities and disclosure to consumer reporting agencies. Covered entities may retain third parties, such as collection agencies, to assist in the performance of payment activities. The HIPAA law permits covered entities to share PHI with these third parties and permits these third parties to use and disclose PHI as necessary to perform functions on behalf of covered entities.

According to our records, you had two accounts placed for collection. A balance of $10.00 attributable to a co-payment, was placed with "CA" for collection. A balance of $63.00, attributable to XXX determined by "ins co" to be non-covered, was placed with "2nd CA" for collection. If you have any questions contact "X"."

Okay, well, duh on the HIPAA section. CA is reporting $175 for the bill (which did have a $10 co-pay, paid at TOS, but there is no way I have a receipt for that at this point. If it were truly $10 owed, shouldn't it be REPORTING $10? The other $63 was removed much earlier in the HIPAA process. I'll be happy to pay another $10 to get this off, but I'm still ticked at how it's reporting.

What should be the next step for this one? It's only reporting on EQ, do I go ahead with the next step of the HIPAA dispute and send a copy of the EOB showing it was paid to EQ?

I am afraid I have lost track of what you have actually done.

You opted out?
You disputed old addresses?
You sent the initial dispute letter to the CRAs?
You had NOTHING deleted as a result??
You sent the medical DV to the reporting CAs?
You sent the follow up dispute to the CRAs??

If the response you cited was from the HIPAA letter insert "b" with the EOB than the next steps are posted following insert "c" on the HIPAA letter program. The letter they sent you is a standard response without any effect on the program.


Yes, I have done all of the above in order except for the follow up dispute. In the process, several accounts were deleted, just not these final few. The follow up to CRA was the step I was on when I got this letter back from the OC. Should I go ahead and send in what they claim to be the $10 copay still owing on the one I have the EOB for and try again with insert A? I'm just trying to figure out if I owe them $10, why they are reporting it at $175.

Send the follow up dispute to the CRA. It would be pointless to pay it to the OC as there is OBVIOUSLY no current business relationship between the OC and the reporting CA




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