Starting the HIPAA Process!

[Nicole C.]

So I've been reading over everything and I am so confused! I figured it couldn't hurt to ask how to proceed in all this. Long story, A collection just showed up on my credit report. Took me by surprise and I had no idea I owed this dentist office a thing as insurance had said it would be taken care of. The dentistry office claims to have documented phone calls and sent letters... but I can honestly say I haven't heard anything. They've hired a collection agency to collect on their behalf and refuse to deal with me regarding the matter. They only direct me to the CA since they've already paid the fee. By the way, this service visit took place around 5 months ago.

 

The OC does not appear on my credit report, only the CA. I don't mind paying this debt if it will make it go away. From what I understand, paying the CA will do nothing for me. So what do I do at this point? Which letters do I send and to whom? I see letters being sent to the OC, The CRAs, the CA...I'm just not sure what I'm supposed to be doing. I just want to do the right steps.

 

Any help is greatly appreciated, as this is the only negative and it's killing my credit at a very important time.

[Nicole C.]

I'm assuming I should write the letters to the Reporting Agencies first...so I'm working on that now.

[Why Chat]

So I've been reading over everything and I am so confused! I figured it couldn't hurt to ask how to proceed in all this. Long story, A collection just showed up on my credit report. Took me by surprise and I had no idea I owed this dentist office a thing as insurance had said it would be taken care of. The dentistry office claims to have documented phone calls and sent letters... but I can honestly say I haven't heard anything. They've hired a collection agency to collect on their behalf and refuse to deal with me regarding the matter. They only direct me to the CA since they've already paid the fee. By the way, this service visit took place around 5 months ago.

 

The OC does not appear on my credit report, only the CA. I don't mind paying this debt if it will make it go away. From what I understand, paying the CA will do nothing for me. So what do I do at this point? Which letters do I send and to whom? I see letters being sent to the OC, The CRAs, the CA...I'm just not sure what I'm supposed to be doing. I just want to do the right steps.

 

Any help is greatly appreciated, as this is the only negative and it's killing my credit at a very important time.

Because this is such a recent bill, your best bet is to check with your insurance and get a copy of the EOMB, ( explanation of medical benefits) to see IF the claim was submitted, IF there was a valid "left over" balance and IF there is anything legitimately owed to the OC.

 

In the meantime, Opt Out

http://www.whychat.5u.com/OPTOUTINST.HTML

 

Send each CRA where this account is reporting this:

http://www.whychat.5u.com/hipaadisp.html

 

There are several possibilities since you haven't received anything from the OC, have you moved?? If so, they may not have had your current address. It is also possible that they mixed your account up with someone else's, are charging you the difference between what your insurance allowed and the original amount ( which they are OBLIGATED to write off) or that your insurance never received the claim.

 

Sending the initial dispute letter will establish a "base line" of communication to get this off your reports. Opting out FIRST is essential to prevent your reports being "poisoned" by garbage CAs especially if you are in the process of buying a home or refinancing.

[Nicole C.]

Thank you! I am in the process of contacting the insurance to have them explain the claims. The ones I were able to obtain electronically are not explaining the amount that is reported on my report nor do they seem right. In the mean time, I have written my letters on legal paper and will send them certified today. I want this gone as soon as possible.

[Nicole C.]

To update and keep myself straight:

 

I've been able to get EOB for every visit. Since my mom paid a majority of the time, I'm waiting on her to get me the card statements showing the exact amount she paid. I will compare them to what the EOBs say we owe the office. The odd thing is, the report is saying I became delinquent in Nov. My last visit was in November. There's also an instance where I paid them more than the insurance company EOB determined me to owe. That amount was never credited back to me, applied elsewhere, or even mentioned by the office. My last visit was in Nov, but I have EOB letters dated in January. In instances where I can see a balance being valid, I have the issue of not receiving any bills or phone calls...

 

I considered asking the office for my records and more info, but they were very nasty and unwilling to work with me when I originally called to politely request that they recall the debt from the CA so I could pay them. At first I was thinking I would need proof the bills were sent and I received them, as well as call dates and times to compare to my phone records.....but from what I read they aren't legally required to do that before sending a debt to collections?

 

I'm assuming the dispute letters to the CRAs are supposed to handle all these discrepancies and confusion? This is looking like a big mess.

[Why Chat]

To update and keep myself straight:

 

I've been able to get EOB for every visit. Since my mom paid a majority of the time, I'm waiting on her to get me the card statements showing the exact amount she paid. I will compare them to what the EOBs say we owe the office. The odd thing is, the report is saying I became delinquent in Nov. My last visit was in November. There's also an instance where I paid them more than the insurance company EOB determined me to owe. That amount was never credited back to me, applied elsewhere, or even mentioned by the office. My last visit was in Nov, but I have EOB letters dated in January. In instances where I can see a balance being valid, I have the issue of not receiving any bills or phone calls...

 

I considered asking the office for my records and more info, but they were very nasty and unwilling to work with me when I originally called to politely request that they recall the debt from the CA so I could pay them. At first I was thinking I would need proof the bills were sent and I received them, as well as call dates and times to compare to my phone records.....but from what I read they aren't legally required to do that before sending a debt to collections?

 

I'm assuming the dispute letters to the CRAs are supposed to handle all these discrepancies and confusion? This is looking like a big mess.

You will likely have to send them ( the OC) the HIPAA letter with a combination of insert "a" and insert "b" as OR insert "b" if there is NO balance payment due as follows:

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

 

Enclosed please find my remittance of ($___) for payment in full of the balance of this account.

The balance due is based on my EOMBs from my insurance( attached) and payments of record of:$xx

( proof of payments attached) This includes a credit of $xx for an overpayment on xx/xx/xxxx

 

Please note, my remittance is payable ONLY to (hc provider) and may not be signed over or transferred to any third party collection agency, as this would constitute an additional violation of HIPAA and State Privacy Act rules .

Copies of this correspondence and a copy of the remittance check may be used for any further actions with State or Federal agencies

 

 

OR

This account is a billing error.

 

It has been paid,based on my EOMBs ( attached] from my insurance and payments of record of:$xx

( proof of payments attached) This includes a credit of $xx for an overpayment on xx/xx/xxxx

 

 

It is not a valid bill and has been properly disputed, therefore I request complete deletion from all your agent (name of CA)'s records and archives.

[Nicole C.]

The 30 days has passed on most of my letters to the CRAs (except Experian...that was sent a bit later.) I've yet to receive an official response from any of them.I checked Ex and EQ and they are still listed. Experian report stated that it's unchanged from my dispute so I assume they consider it valid. How should I proceed? I get that I will have to send the OC the above, but do I need to send the CA anything? They still have yet to make a move to contact me. No mail, no calls, nothing at all.

Edited July 15, 2012 by Nicole C.

[Why Chat]

The 30 days has passed on most of my letters to the CRAs (except Experian...that was sent a bit later.) I've yet to receive an official response from any of them.I checked Ex and EQ and they are still listed. Experian report stated that it's unchanged from my dispute so I assume they consider it valid. How should I proceed? I get that I will have to send the OC the above, but do I need to send the CA anything? They still have yet to make a move to contact me. No mail, no calls, nothing at all.

Wait until you have a response from the CRAs.

 

NO, do NOT contact the CA, send the letter to the OC, then if there is no change on your reports, send the follow up dispute ( follows insert "c") and a copy with cover letter to the OC.

[Nicole C.]

I'm in the process of sending the money order to the OC. I've had to wait since I just moved. Crossing my fingers that this works. I hope it's alright that I use the OC's bills as proof of payment, as they have the amounts I paid them per their office. Since my total amount owed comes from multiple visits, how do put on paper the various differences owed?

[Nicole C.]

Money order sent, along with EOBs and proof of payments...now hoping they cash it and all works out. There's a few things the office didn't even try to bill to insurance and aren't on my EOB. I'm still going to pay since they're smaller, but I don't understand it.

[Why Chat]

Money order sent, along with EOBs and proof of payments...now hoping they cash it and all works out. There's a few things the office didn't even try to bill to insurance and aren't on my EOB. I'm still going to pay since they're smaller, but I don't understand it.

Have you STILL not received ANY response from the CRAs?? Check on line ( back door) you may not be seeing updated reports. Do you have the printout of the certified mail from the disputes you sent them??

[Nicole C.]

Oh, yes. They all came back verified.

[Nicole C.]

I have my green card back. The office must be sitting on the money order or unsure of what to do, because it's been a week and the money order still hasn't been cashed. I call to check the status and the bank tells me it hasn't cleared. How long do I give them? And what is my next course of action should they not cash the money order?

[Why Chat]

I have my green card back. The office must be sitting on the money order or unsure of what to do, because it's been a week and the money order still hasn't been cashed. I call to check the status and the bank tells me it hasn't cleared. How long do I give them? And what is my next course of action should they not cash the money order?

It can take up to several Months for the OC to deposit the money order, they need to figure out how to handle it as it is outside their normal procedures.

 

If it is NOT deposited within 2 months, then you call them and ask for their security office. Tell them that you are concerned because they received a payment that was signed for( give the name of signer) but it was not deposited and you are afraid it may have been misappropriated.

Edited September 15, 2012 by Why Chat

[Nicole C.]

I have my green card back. The office must be sitting on the money order or unsure of what to do, because it's been a week and the money order still hasn't been cashed. I call to check the status and the bank tells me it hasn't cleared. How long do I give them? And what is my next course of action should they not cash the money order?

It can take up to several Months for the OC to deposit the money order, they need to figure out how to handle it as it is outside their normal procedures.

 

If it is NOT deposited within 2 months, then you call them and ask for their security office. Tell them that you are concerned because they received a payment that was signed for( give the name of signer) but it was not deposited and you are afraid it may have been misappropriated.

 

The OC in my case is a pretty small operation. There's only one dentist and a few other workers.I was hoping for a quick response but I'll wait it out and keep hoping!

[Nicole C.]

To update, Since it's officially been 2 months I will be calling the office next month. They've called a few times in attempt to get me back to the office for services. If only they'd have put some effort into contacting me about the balance before they sent me off to collections!

 

Anyway, as I mentioned it is a small operation. The one dentist that was there has since sold it (I assume) because she is no longer the dentist there and has moved. My EOBs actually show the dentist's name as the one being paid. If she is no longer there, I'm wondering if there is anything they can even do with the money order? I made it out to the dentistry and not the dentist herself.

[Nicole C.]

I called the office and they have no record of the payment. After telling them I sent it certified and it was signed for, they said they most likely forwarded it to the the previous dentist whom provided my services. At this point they say there is nothing they can do since I don't owe the office but the dentist, and she's no longer there.

 

What is my next step?

[Why Chat]

I called the office and they have no record of the payment. After telling them I sent it certified and it was signed for, they said they most likely forwarded it to the the previous dentist whom provided my services. At this point they say there is nothing they can do since I don't owe the office but the dentist, and she's no longer there.

 

What is my next step?

Send the reporting CA this:

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

 

Check with the bank and see if the money order was deposited.

[Nicole C.]

I just checked the money order status and it was paid on November 2nd. It really did take close to 2 months! But I'm glad she finally cashed it. I'll go ahead and send the letters to the CA this week. Hard to imagine this is still going on for six months now, but it beats the heck out of seven years.

[Nicole C.]

The CA has picked up my certified letter (no RR due to the PO Box) but they haven't responded. I'm wondering what (ideally) the next action would be? I assume the letter is to get the CA to attempt validation and be unable to? As said the dentist is no longer there but she has cashed the money order. I assume she did not communicate with the CA though.

[Why Chat]

The CA has picked up my certified letter (no RR due to the PO Box) but they haven't responded. I'm wondering what (ideally) the next action would be? I assume the letter is to get the CA to attempt validation and be unable to? As said the dentist is no longer there but she has cashed the money order. I assume she did not communicate with the CA though.

No, the next step is to send the follow up disputes to the CRAs

http://www.whychat.5u.com/ltrcavalhipaa.html#DISPUTE

[Nicole C.]

I'll be sending off my letters to the CRAs tomorrow. I just checked my fico and this collection is still murdering my score. I notice that my money order really doesn't come into play in my letter. What role does the money order play in the validation of the debt? I don't know why the dentist cashed it but ignored the letter and the CA. I'm starting to wonder if the CA and the Dentist even have a relationship at this point. The CA has still not attempted to contact me nor have they made any attempt to validate the debt.

 

I'm crossing my fingers that the CRAs delete this account after this next round of letters.

 

 

[Why Chat]

I'll be sending off my letters to the CRAs tomorrow. I just checked my fico and this collection is still murdering my score. I notice that my money order really doesn't come into play in my letter. What role does the money order play in the validation of the debt? I don't know why the dentist cashed it but ignored the letter and the CA. I'm starting to wonder if the CA and the Dentist even have a relationship at this point. The CA has still not attempted to contact me nor have they made any attempt to validate the debt.

 

I'm crossing my fingers that the CRAs delete this account after this next round of letters.

Are you saying that you paid the dentist BEFORE establishing a current relationship between the dentist and the reporting CA??

Edited December 28, 2012 by Why Chat

[Nicole C.]

I'll be sending off my letters to the CRAs tomorrow. I just checked my fico and this collection is still murdering my score. I notice that my money order really doesn't come into play in my letter. What role does the money order play in the validation of the debt? I don't know why the dentist cashed it but ignored the letter and the CA. I'm starting to wonder if the CA and the Dentist even have a relationship at this point. The CA has still not attempted to contact me nor have they made any attempt to validate the debt.

 

I'm crossing my fingers that the CRAs delete this account after this next round of letters.

Are you saying that you paid the dentist BEFORE establishing a current relationship between the dentist and the reporting CA??

 

Up until the point I sent the money order, they had a current relationship to my knowledge even though the CA never sent me anything validating that fact. The dentist's office referred me to the CA back when I called about the debt and they were definitely working with the dentist's office. When I called about the money order not being cashed, I was told it was mailed to the dentist as she had sold the office and moved out of the state. Apparently I owe the dentist personally and not the office in general. So, the dentist that provided my services is gone and I have no idea where to or what the means for the CA relationship.

 

I paid the dentist while the relationship (to my knowledge) was current. It took her 2 months to cash it and she did so after she'd sold the office and moved.

[Why Chat]

I'll be sending off my letters to the CRAs tomorrow. I just checked my fico and this collection is still murdering my score. I notice that my money order really doesn't come into play in my letter. What role does the money order play in the validation of the debt? I don't know why the dentist cashed it but ignored the letter and the CA. I'm starting to wonder if the CA and the Dentist even have a relationship at this point. The CA has still not attempted to contact me nor have they made any attempt to validate the debt.

 

I'm crossing my fingers that the CRAs delete this account after this next round of letters.

Are you saying that you paid the dentist BEFORE establishing a current relationship between the dentist and the reporting CA??

 

Up until the point I sent the money order, they had a current relationship to my knowledge even though the CA never sent me anything validating that fact. The dentist's office referred me to the CA back when I called about the debt and they were definitely working with the dentist's office. When I called about the money order not being cashed, I was told it was mailed to the dentist as she had sold the office and moved out of the state. Apparently I owe the dentist personally and not the office in general. So, the dentist that provided my services is gone and I have no idea where to or what the means for the CA relationship.

 

I paid the dentist while the relationship (to my knowledge) was current. It took her 2 months to cash it and she did so after she'd sold the office and moved.

OK, you need to continue disputing, check the deposit of the money order and try to get the current address of the dentist. If she is still licensed, even in another State you may still be able to use the follow up disputes.