QUOTE (Jarvik @ Sep 18 2009, 03:22 PM)

Hi,
I've opted out, old addresses and info is gone.
All 3 CRA's reporting
The account was reported in 12/08
I sent initial DV to CA then I sent dispute to CRA's what KIND of dispute??
hey came back verified.
Ok so long story.
had an emergency room visit in August 2008. I have insurance with xxx and the hospital xxxx is under-contract as in-network.
First notice that the bill was unpaid was a hit on my credit in as I have credit watch. . I never received a bill from the hospital for this visit. No notice or letter from collections was sent
I immediately called Insurance co and discussed this with them. We called the hospital and they wouldn't talk to me or my insurance agent, and would only transfer us to the first Collection Agency NCO.
Insurance got on the phone with NCO and myself and explained I was insured. Hospital claims I never submitted insurance, but at that time insurance co gave them this info so they could re-submit the claim. I have been visiting this Medical Center for several years and had insurance claims process previous to this and as recent as January 1 2009.
Medical Center resubmitted the claim to insurance, I talked with NCO dispute dept, and asked them to send a request for removal to the CRA's as I was not responsible for this debt and Insurance was. Within 24 hours, it was gone from my credit reports.
insurance then denied the claim as it wasn't filed in a timely manner. In my statement it said "1. You are not responsible for this charge, because the provider did not file the claim within the required time limit. "
This is because under the hospital in-network contract, they have to file within a certain time for patients that are covered by the contracted insurance company.
June 15, I receive a collections letter from Central Financial Control, asking for the full amount xxx.xx, with an adjustment of xxx.xx, and added interest of x,xx totaling $xxx.xx
I call insurance, walk through the history of my previous rounds with NCO.
June 16th- We call Central Financial Control, AKA Syndicated Office Systems, AKA Tenet Healthcare.
Walk through this once again, I was insured, this hospital is an in-network hospital, they didn't file the claim in a timely manner. They explain this to Central Financial Control/Syndicated Office systems, who then states that I didn't give my insurance and they did not have it. This is untrue as my insurance eom statements clearly show many claims with Medical Center.
Insurance then reprocesses the claim. And explains to Central Financial Control that I am insured under Insurance plan, Medical Center is an in-network provider and this should have never gone to collections.
June 24th- I have insurance get on the phone and call them the day they sent payment, and the day it would arrive.
Insurance and I discuss my concerns of my co-payment. They paid the Hospital/OC directly, but how do I make my payment to the hospital when I don't have an account or even a bill showing what I owe!
Insurance and I get on the phone with the CFC/Syndicated Office Systems, I have to pay the co-pay to the Hospital itself but send it to CFC. The Insurance agent, told them what my co-pay was as well.
I expressed my concern that I didn't want this to hit my credit as this being flagged to for submission to CRA's.
CFC/SOS told myself and my Insurance insurance agent that it wouldn't hit my credit and I would have 30 days, before it was sent to the CRA's
That is, 30 days from the day that Insurance processed my claim and sent the payment. The Insurance agent has this documented in my claim history!
At this point I was told by CFC/SOS that my credit file was not affected but, "your account has been flagged to be sent to CRA's" as a collection Item. Insurance and myself explained that payment had been made I only needed a bill for services rendered from the hospital to make my payment of my co-pay. CFC/SOS stated I would receive a bill from the hospital and would be able to pay.
June 30th - Insurance paid on June 30th. CFC sent to CRA's and hit my credit 10 days later.
Showing original balance owed as the contracted amount between Insurance and Hospital and amount owed as much less than my co-pay.
I told the Insurance agent this and he stated it was balance billing, he also filed a complaint against the hospital within Insurance co..
I've filed a complaint with the office of consumer affairs as well.
This is the basic rundown. I didn't find this site until after I had the insurance co contact the CA and the OC.
I have all of this documented and so does my insurance co.
Basically now they still have a tradeline open on my credit with the dates, the orig balance and the amount owed wrong. It came back verified because they only verify from the reporting agency if its correct. They said it is, so viola! It stays. They have no obligation to check back to the OC, because the OC is not the reporting agency.
The main problem I have, I cant use legal tactics against one of the main CRA's because I work for one...Yeah you'd think I wouldn't be in this position...
OK, you can use a variation of the HIPAA letter program without using any "legal" stuff against any CRA.
You still need to dispute the account PROPERLY, use this even if it seems silly, since you know how disputes are handled by any CRA you know why the instructions are important to avoid an automated response.
http://whychat.5u.com/hipaadisp.htmlAt the SAME TIME, if you have any kind of documented bill for the co-pay balance you do owe, pay it directly to the OC with the HIPAA letter insert "a". Be SURE to follow ALL the directions very carefully. DO NOT contact the reporting CA.
http://whychat.5u.com/hipltr.htmlPost back here in this thread for added questions or further instructions.