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Kles

Medical Violation?

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My mother joined a website which is free for the 1st two months ($9.95 after) that disputes collections for you. They supposedly go after the violations (if any) for you in court.

 

She had a medical collection for $72.89 from Savit collection agency.

 

Savit mailed a letter to her yesterday saying they confirmed her name, address, & amount due and attributed the balance as her Medicare co-insurance responsibility.

 

The second page is a copy of her bill with her name, social (they scribbled out the first 6 digits) , the dates and the medical procedures performed. - isnt that a violation?

 

My mom also had two insurances - Medicare &. Medicaid though the state. Do I contact the doctors office and ask them to bill the balance to Medicaid? Or can I go after the Savit for a violation?

Edited by Kles

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I would first contact the billing dept of original creditor/medical facility and inquire if they billed Medi-Cal/Medicaid or, did they just bill Medicare.

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Savit mailed a letter to her yesterday saying they confirmed her name, address, & amount due and attributed the balance as her Medicare co-insurance responsibility.

 

The second page is a copy of her bill with her name, social (they scribbled out the first 6 digits) , the dates and the medical procedures performed. - isnt that a violation?

 

If Savit has a business relationship with the medical provider it is not a violation for them to get copies of bills and medical records to respond to a dispute about the collection.

 

 

My mom also had two insurances - Medicare &. Medicaid though the state. Do I contact the doctors office and ask them to bill the balance to Medicaid? Or can I go after the Savit for a violation?

 

You can contact and ask if they are a Medicaid provider and will bill them. There is a time limit to do so. If the provider is not a Medicaid participant then it won't be covered and would have to be paid by her.

 

There is no private right of action for a HIPAA violation and even if there was you would not have standing to pursue it.

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Savit mailed a letter to her yesterday saying they confirmed her name, address, & amount due and attributed the balance as her Medicare co-insurance responsibility.

 

The second page is a copy of her bill with her name, social (they scribbled out the first 6 digits) , the dates and the medical procedures performed. - isnt that a violation?

 

If Savit has a business relationship with the medical provider it is not a violation for them to get copies of bills and medical records to respond to a dispute about the collection.

 

 

My mom also had two insurances - Medicare &. Medicaid though the state. Do I contact the doctors office and ask them to bill the balance to Medicaid? Or can I go after the Savit for a violation?

 

You can contact and ask if they are a Medicaid provider and will bill them. There is a time limit to do so. If the provider is not a Medicaid participant then it won't be covered and would have to be paid by her.

 

There is no private right of action for a HIPAA violation and even if there was you would not have standing to pursue it.

 

Thank you, I am trying to track down the doctors office now to see if they can bill the 2nd insurance. Why do you say I have no standing to purse even if there was violation?

Edited by Kles

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I am sorry your mother joined the website that claims to be able to dispute her errors on her credit report.

 

The CRAs ( credit reporting agencies) are very regulated by Federal laws for CONSUMER disputes, however disputes sent by CROs ( credit repair organizations) such as the website she joined are handled differently and she has none of the protection of the FACTA ( Fair And Accurate Credit Transactions Act);

https://www.ftc.gov/enforcement/statutes/fair-accurate-credit-transactions-act-2003

 

I suggest you tell your mother to cancel her membership with the CRO and follow the assistance she can get here for free.

 

As to HIPAA violations. The only actions HIPAA can take are against the provider to sanction them for any violations ( which in your mother's case do not appear to have occurred). The fines and penalties are against the violators and there is no $$ recovery available to the victim of errors or misdeeds, which is what "kles"was referring to when he said there is no private "standing".

 

Have your mother follow these simple steps in the guide to get rid of the collection account ( which the reporting CA probably obtained from a data miner and not directly from the OC hospital)

 

https://whychat.me/GUIDEBOOK.html

https://whychat.me/GUIDE%20HIPAA%20PROGRAM.html

 

The initial dispute to the CRAs will likely solve the problem and her opting out may help prevent further JDBs ( junk debt buyers) from harassing her

https://whychat.me/hipaadisp.html

 

If this doesn't solve her problem, come back to this post for further assistance.

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Thank you, I am trying to track down the doctors office now to see if they can bill the 2nd insurance. Why do you say I have no standing to purse even if there was violation?

 

The HIPAA law does not provide for individual patients to pursue monetary compensation for violations. The consequence to a provider for violating the law ranges from a warning to fines. What they are hit with depends on the severity of the violation. The best example I can give you is a large hospital system in California SELF reported HIPAA violations to the DHS when they had a half dozen employees who accessed the medical records of celebrities who came to the facility for treatment. The hospital thought by self reporting they would get a warning or sanction but it was worse. They got hit with a fine of several hundred thousand dollars. The celebrity/patients whose records were compromised could not sue for the HIPAA violations.

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I am sorry your mother joined the website that claims to be able to dispute her errors on her credit report.

 

The CRAs ( credit reporting agencies) are very regulated by Federal laws for CONSUMER disputes, however disputes sent by CROs ( credit repair organizations) such as the website she joined are handled differently and she has none of the protection of the FACTA ( Fair And Accurate Credit Transactions Act);

https://www.ftc.gov/enforcement/statutes/fair-accurate-credit-transactions-act-2003

 

I suggest you tell your mother to cancel her membership with the CRO and follow the assistance she can get here for free.

 

As to HIPAA violations. The only actions HIPAA can take are against the provider to sanction them for any violations ( which in your mother's case do not appear to have occurred). The fines and penalties are against the violators and there is no $$ recovery available to the victim of errors or misdeeds, which is what "kles"was referring to when he said there is no private "standing".

 

Have your mother follow these simple steps in the guide to get rid of the collection account ( which the reporting CA probably obtained from a data miner and not directly from the OC hospital)

 

https://whychat.me/GUIDEBOOK.html

https://whychat.me/GUIDE%20HIPAA%20PROGRAM.html

 

The initial dispute to the CRAs will likely solve the problem and her opting out may help prevent further JDBs ( junk debt buyers) from harassing her

https://whychat.me/hipaadisp.html

 

If this doesn't solve her problem, come back to this post for further assistance.

My mom lives in a senior community and apparently they had a “credit repair” workshop, which is how she signed up for that “free” site.

 

I had sent away for her reports and will guide her through your steps. Thank you very much

 

Hopefully it does get removed , but I feel her second Insurance should have picked up that cost.

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Her 2nd insurance probably DID pick up the cost. If she can obtain her EOMB ( explanation of medical benefits) from her secondary insurance you will likely find that they paid their portion of the bill and that the reported account on her credit report is invalid and comes from a JDB ( junk debt buyer) who obtained it from a data miner. I would guess that the "credit repair workshop" was sponsored by the same people who profit from this CRO ( credit repair organization)

Edited by Why Chat

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Her 2nd insurance probably DID pick up the cost. If she can obtain her EOMB ( explanation of medical benefits) from her secondary insurance you will likely find that they paid their portion of the bill and that the reported account on her credit report is invalid and comes from a JDB ( junk debt buyer) who obtained it from a data miner. I would guess that the "credit repair workshop" was sponsored by the same people who profit from this CRO ( credit repair organization)

 

 

Thank you aagin WhyChat, I will contact her 2nd insurance tomorrow morning.

 

I've opted her out & will send in the request to remove alternate names & old addresses as soon as I get them.

 

I will be sure to come update on the progress!

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Her 2nd insurance probably DID pick up the cost. If she can obtain her EOMB ( explanation of medical benefits) from her secondary insurance you will likely find that they paid their portion of the bill and that the reported account on her credit report is invalid and comes from a JDB ( junk debt buyer) who obtained it from a data miner. I would guess that the "credit repair workshop" was sponsored by the same people who profit from this CRO ( credit repair organization)

 

Still haven't received her credit reports yet.

 

I did call Medicare and they said a request to put the claim "back online" because it has already been purged from the system. I have to call back in 7-10 business days to get a copy of the claim.

 

I also called Medicaid and was told that in Feb 2012 she had straight Medicaid no HMO but she said she was unable to provide me with any documentation.

 

I've googled the doctor who the bill is for & when I call the office that's listed they say he doesn't work for them.

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It would be better for you not to try to contact the Dr as I am VERY SURE that his office had nothing to do with the account being reported by the CA. Do make sure that your mother's data is eradicated from the "credit repair" organization she signed up for and I suggest that you consider discussing the matter of vulnerable seniors being coerced into providing their personal data to an outside credit repair organization is dangerous ( and possibly illegal)

 

BTW- Did you ever see "Better Call Saul"?? That series shows how vulnerable nursing home residents are to crooks and manipulative schemes.

Edited by Why Chat

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