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Negotiating strategy with CA over medical bills

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Background: The company I work for has horrible insurance. They offer only one plan with a $2,000 individual deductible and $5,000 family deductible. After that they only pay 70% of the UCR up to an out-of-pocket maximum of $10,000. In August of 2019 I had to have an endoscopy/colonoscopy for a total of $8500 in charges. My portion is $4000. I applied for Care Credit and a personal loan from my credit union and was denied. The surgical center and the doctors are all billed under the same entity. I met with the direction of patient finance and she politely, but firmly, told me their policy was for patients to pay their balance-in-full within 90-days or the account will be turned over to a CA. My budget allows for no more than $100/month towards the $4000 debt. I paid a total of $300 towards the debt ($100 each month) before they punctually sent me to an outside CA. I have spoken to the CA three times. They are insistent that the debt be paid within 12-months ($308/month). So far they haven't budged off that amount. I've dealt with CA's years ago and they almost always are willing to negotiate payments, so this situation has me scratching my head. 

 

Strategy: In the three months since the CA has contacted me I've "deposited" $300 ($100 each month) into a sub-fund with my bank. Actually, it's all in one savings account but my online banking allows me to set up different funds in order to save for specific needs. The last time I spoke to the CA I told them that I could not afford more than $100/month. They refused this offer. I also told them that until they are willing to accept my offer I will be putting their $100/month aside for them until they are finally willing to accept it. So, hypothetically, if they finally agree to my terms six months from now, I will have a total of $900 to send them towards the $4000 debt. So far they haven't indicated they are going to sue me, although I know that's possible. 

 

I haven't written the CA a cease and desist letter because I don't want them to have no other option but to file a lawsuit. The CA only has my Google Voice number. I let them leave a message and then I call them back on my schedule. I must sound like a broken record because I say the same thing to them each time. "Are you willing to accept my offer of $100/month with an upfront payment of the funds I already have saved towards this debt?" 

 

Question: Is my strategy a wise one? Is there something I'm not doing that I should be doing? Should I change strategies? Why is this CA so unwilling to negotiate? I'm not in collections with anyone else. This is it. 

 

Thank you in advance for your replies. 

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Do you have your EOMBs from your medical visits?? Double check to make sure that the amount you are being billed for is accurate. (Insurance allowed amount minus insurance paid amount). You should see a line of what was billed, what was ALLOWED and what was paid and how much was left as patient responsibility. Look up the normal and reasonable charges here:

https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/HealthCareConInit/index?redirect=/HealthCareConInit/

 

Do you qualify for any State assistance?? Was any assistance offered??

 

When you were paying the hospital $100 a Month did you get any accounting from the hospital?? Did you sign any agreement with them??

 

At some point the current CA MAY decide to sue you for the balance due. If so, and if you were able to demonstrate that the billing was inaccurate or exorbitant or not in line with  reasonable and normal billing costs you would be able to combat them in small claims court yourself. On the other hand, if you take steps to protect yourself now and the current CA turns the account over to another CA you will be in a better position to fight them.

 

Meanwhile, follow this guide;

https://whychat.me/GUIDEBOOK.html

 

At some point down the line, you may be able to pay the hospital directly a discounted settlement amount using the HIPAA letter insert "a".

https://whychat.me/hipltr.html

 

Negotiating with a CA is like waving a red flag in front of a bull!!

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Posted (edited)
5 hours ago, Aschan said:

Why is this CA so unwilling to negotiate?

Because few patients actually follow through on the payments at all.  On top of that at $100 a month that would be 3 years worth of payments.  The CA knows when it comes to medical debt the longer someone wants to make payments the greater the chances they never finish the process and pay off the balance.

 

Another possibility is that the contract for collections with the surgery center and physicians requires they not go beyond one year on payments.  Since the SOL for a lawsuit could be as short as 3 years depending on what state you are in they want to ensure if patients default they can still pursue a suit through the courts on the balance.

 

Edited by CreditSucksNot
added information

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5 hours ago, Aschan said:

The company I work for has horrible insurance. They offer only one plan with a $2,000 individual deductible and $5,000 family deductible. After that they only pay 70% of the UCR up to an out-of-pocket maximum of $10,000. In August of 2019 I had to have an endoscopy/colonoscopy for a total of $8500 in charges. My portion is $4000.

One thing to keep in mind for future care is that you are not required to use your insurance.  Many times the cash pay price is better than if you used your policy.  What that means is you have to ask the surgery center and/or physician what the cash pay price is.  They will tell you.  That would have to be paid up front but the discount is many times worth it vs. the out of pocket expense under a policy.  If you do this you cannot submit what you paid to your carrier.  That would automatically trigger contractual obligations under the policy with regards to out of pocket expenses and negates the cash price discount.

 

What the providers cannot do is bill your insurance AND offer you charity care or a discount.  That is illegal rebating and violates the terms of your health care policy.  You must choose up front to either pay a discounted price without coverage or use your policy.  Unfortunately you cannot do both.

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"CreditSucksNot" is mistaken. The "cash" price is going to be MORE than your share of the insurance payment as the insurance has already negotiated the lowest possible approved amount. In addition, it is NOT illegal to obtain financial assistance with deductibles and co-pays if you qualify.

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2 hours ago, Why Chat said:

The "cash" price is going to be MORE than your share of the insurance payment as the insurance has already negotiated the lowest possible approved amount.

Not true. I just had an MRI.  The negotiated contractual price through my insurance (a major named carrier) made my portion $700.  The cash price if I paid up front and they didn't have to deal with my carrier was $550.  (not to mention the cash back on the credit card I paid with) My best friend just had an upper GI/colonoscopy same as the OP and got a better cash price paying up front than her out of pocket on her policy which is through BC/BS. We both routinely ask about the cash price vs. coverage on anything that is not routine care.  It is becoming more and more common.  In fact the largest radiology service in our county advertises to ask about cash pricing instead of using your coverage.

 

Paying cash happens a LOT more now that the Affordable Care Act forced many into expensive policies.  They keep the coverage for catastrophic expense shielding but pay out of pocket as it is less money.  Those policies also have requirements under the ACA which includes NOT discounting the out of pocket portion if the coverage has been used.  That means a provider cannot waive co-pays or deductibles or reduce them.  What the EOB says is what the patient is supposed to pay the provider.  They also cannot deny a policy or cancel it based upon pre-existing medical conditions, and the carrier must spend $0.85 of ever dollar on medical care not their profit margin.  

 

The providers can charge less than an insurance contract for cash paying patients because they do not have to wait to get paid for 30 days to 6 months by the carrier or fight a denial for a bogus reason to avoid paying.  They get paid up front before services are rendered.  Having to employ multiple people to file and fight claims is costly to the provider in salary, benefits, and overhead.  Having to send the patient to collections because they don't pay their contractual portion is even more costly.

 

In this thread the OP went to a surgery center.  They are privately owned and do not offer charity care.  The surgeons here are required to have an ownership stake to even use one.   At least once a month one of my surgical cases gets cancelled because the surgery center will not allow the patient to get their procedure done because they cannot pay their out of pocket portion/deductible before being admitted.  I am surprised the surgery center the OP went to allowed the procedure to be done without a significant cash payment up front on that expected large out of pocket portion.  Even so, nothing requires they agree to the payment plan the OP wants.  No one can predict if they will resort to a lawsuit to collect (which more and more providers are doing) but a quick scan of the local court docket could yield that information.

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Every situation is different. That is why I deal with each poster on an individual basis. In the case of THIS poster his accounts were sloughed off by the health care providers within a relatively short time AFTER he paid them $300. towards his deductibles and co-pays. If the amount involved had been for ONE procedure the advice I gave would have been valid as additional assistance for catastrophic charges are available through most State and County programs. However, in THIS CASE the accounts were obviously written off by the HC providers after he paid over 20% of the larger charges. The current CAs reporting are likely JDBs.

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Unfortunately, I lacked the financial resources to pay cash up front. I did verify the charges on the E.O.B. and they were correct. 

 

As to the $300 I paid towards my medical debt; I didn't have an agreement with the health care provider to do this. This H.C.P. is well-known in the local area for having a quick trigger on sending accounts to collection. I knew a CA was going to get the account and I figured there wasn't a reason for me not to get a head start. I'm not that concerned about being sued. Every month that goes by another $100 gets put aside towards this debt. If it gets to the point where I'm actually talking to an attorney I will be able to say, "I have [$1000-$1100-$1200] that I can send you immediately with a written agreement of $100/month until the full amount is paid. If we go to court it's unlikely you'll get a better offer." 

 

I guess I'm just stymied by the fact that the CA will not take my offer seriously. 

 

Thank you for all the responses.

 

 

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Offering a CA a settlement is a signal to them that you are willing and able to pay. They would rather NOT settle in the expectation that they can squeeze the full amount from you.

 

How is it reporting??

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6 hours ago, Why Chat said:

How is it reporting??

It is not reporting yet. It has been a little over 90-days since the CA got the account. I expect it should hit my CR soon. 

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Make sure you are opted out. 

It is POSSIBLE that the CA who got your account was NOT the original CA

Whom exactly did you pay the $300 to?? Was it the collection department of the OC??

 

If the original CA collection service for the OC accepted your $300 and subsequently transferred your account then the "current" CA could not have had your HIPAA release transferred to them and they are not legally permitted to report.

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