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Confirming process, appreciate guidance

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Hello to you all. I'm about ready to begin the HiPAA Letter Program and want to make sure I follow the steps appropriately and use you all as a resource for (hopefully) a successful outcome.

 

General Info:

- $1,967 reported to Experian and Transunion August 2019 as collection account, not reported to Equifax

  •  Original creditor: SUNBEAM POINT EMERGENCY PHYS
  • CA shown on reports: AR Resources
  • EOMB shows I was responsible for $1,889.98 to L Medical Center Inc, service date 12/15/18

 

This is a valid debt according to EOB, however I did not know it was owed and I'm not sure why the amounts are different. I paid a visit to the emergency room in FL (live in CA) December 2018 and provided my insurance information, however I never received anything from the hospital and was never contacted by the collection agency. I did not discover that this was reported to Experian and Transunion until a few weeks ago. I jumped the gun and disputed the collection account online (2/23/10) with both Ex and TU before doing further research as I did not recognize the collection agency. Dumb. Experian validated the account and provided the original creditor, but that is all. Nothing so far from Transunion.

 

So far, I have opted-out and drafted the original dispute form for each CRA. My address has not changed in the past 2 years so I believe I am correct to skip that step. Should I proceed with each step from the beginning even though I disputed online? My goal is to pay the original creditor and have the collection account removed from my reports - is this how I should proceed?

 

Thank you in advance for your help.

 

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If you have opted out and don't need to delete old addresses then the next step is to send the initial dispute letter to the CRAs where it is reporting.

https://whychat.me/hipaadisp.html

 

Make sure you follow the mailing directions in the guides

https://whychat.me/GUIDEBOOK.html

 

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

 

If your online dispute was recent (within the last 90 days) you should wait until 90 days has passed otherwise the CRAs would still have you in their active system and you would get a "previously disputed" response.

 

You say you have verified this through your EOB, was the amount showing as your responsibility due to co-pays and deductibles or were there some disapproved charges.

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@Why Chat Thank you for the response. The online disputes were completed just under 30 days ago, so I will wait a full 90 days before sending the initial dispute letters.

 

My obligation in the EOB was due to copays and deductibles. I had a HDHP at the time.

 

Is there ever a situation where it would make sense to send the HiPAA letter since Experian "validated" the debt? How likely is it that the CA will attempt to make first contact with me now that they have been contacted by the CRA's?

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If the CA contacts you as a result of your online dispute it would mean that they are currently a business associate of the OC and therefore legally allowed to communicate your private health data as they would have received the release you signed. If the CA does NOT contact you it would be more than likely that they are NOT the initial CA and therefore are NOT permitted to communicate your private health data because your HIPAA privacy release can not be "re-transferred" so all they have is the basic account data and can not report or validate.

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@Why Chat Got it, thanks for clarifying. I will now wait two months and start from the beginning. If I happen to start receiving calls or anything in the mail from them, does that change the process at all? Would I proceed to paying the OC directly with the HiPAA letter?

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Calls don't matter. An actual response from the reporting CA with FULL details of your health care visit are required BEFORE you can (or should) pay the OC health care provider.

 

 

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@Why Chat Quick update on current status and a few follow up questions. I have gone through the process up to sending the collection agency validation letter as well as the follow up letter to the CRA's. At this point Equifax and Transuion have opened disputes and confirmed via mail, however they both sent letters for me to confirm my mailing address and requested two forms of identification. Don't see any issues with this.

 

While this was happening, I also contacted the OC via phone and simply requested if they would be able to pull the balance out of collections. They said that they could accept payment and send a request to the CA, but beyond sending the request they can't guarantee what the CA would do. This was not surprising, seems like I hear this all the time. They said I could call the CA to ask what the process would look like, but I have not intention of contacting them other than via mail.

 

My questions is - should I now send the letter to the OC with a cashiers check and avoid payments over the phone? Do I have to just trust that they will actually contact the CA and that the CA will actually report correctly to the CRA's? I'm worried that I will pay the OC and the CA will still report the balance as a collection that was paid.

 

Appreciate your input!

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Why are you so sure that the OC is in a current business relationship with the OC?? Have you had any response from the CRAs or the CA?? If you pay the OC you may be throwing your $ away because IF they do NOT have a current relationship with the reporting CA your payment will have no effect on the reporting. If they DO have a current relationship and you have documentation from them as a result of your initial dispute and you are sure the amount is correct you can pay the OC with the HIPAA letter insert "a".https://whychat.me/hipltr.html

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@Why Chat I don't have anything in writing from the OC confirming there is a valid business relationship, they only thing they confirmed with me is that the balance is indeed in collections and they can send a request to have collections stopped by the CA. Your concerns mirror mine.

 

- I have not received any response form the CA to date

- The CRA's have opened my dispute and requested that I confirm my mailing address with two forms of identification

 

If I continue to not receive a response from the CA, should I request (from the OC) written validation of a business relationship between the OC and CA?

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No, the more you contact the OC the harder it is going to be to get this off your reports. At this point you have no proof that the reporting CA is the ORIGINAL assigned CA. Your communication to the OC provides a possible advantage to the CA to obtain an ACTIVE file. If you had left it alone(with the OC) there would have been a good chance that the account was no longer in their active computer files but had been archived.

 

I am curious as to why the CRAs requested the proof of identity- did you follow the guide?

https://whychat.me/GUIDEBOOK.html

https://whychat.me/hipaadisp.html

Did you include a copy of your report with the account circled??

"Make sure you attach a copy of the pages with the accounts circled from your credit reports."

If so, they should have had your ID,SS# and address from your report.

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@Why Chat The only contact I've had with the OC is the one phone call and don't plan to have any additional communications.

 

When I contacted the CRA's, I did send copies of my reports with the account circled, in red. Experian's mail was more general with language around "you have the right to XYZ" and if you want any of this please provide ID. It does not reference the dispute, it references the report #.

 

Transunion's communication was specific to the dispute and has the following language:

 

"Recently you contacted us to dispute information on your credit report, and we are in the process of investigating. Before we can mail anything to the address you requested, we need proof that the address is accurate so your personal information stays secure.

 

You must submited copies of two (2) of the qualifying documents listed below...."

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OK, TU is notorious for inefficiency and excess paperwork in response. Frequently people have found that they get "verified- remains" notices and requests for additional information but when they get an updated report they find that the disputed account has actually been deleted. Go ahead and send them what they want.

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Hi @Why Chat a few updates:

 

- I sent TU what they requested, so I'll be waiting to see what comes back from them

- Today I received a response back from the CA. Here is what they sent:

 

1. Cover letter with the OC name and my account number, and my account number for the CA

2. A statement from the OC with a statement date of 05/01/20

 

There is nothing that shows that the debt was purchase or that the CA has a right to be collecting on their behalf. Ultimately it just shows that they have a copy of the statement...am I missing something? Interested to know what your recommended next steps would be here. 

 

Thanks!

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The statement date of 05/01/20 would certainly APPEAR to demonstrate a current business relationship. Did your EOMB have a breakdown of what was charged, what was allowed, what was paid and the reason for your responsibility for the $1,889.98?? Co/pay? deductible? Out of plan?

What DID they pay and to whom??Was it to the hospital or were any payments paid to a participating doctor.

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@Why Chat I agree - it does seem that they have a business relationship. EOMB indicates that my responsibility was a combination of co-pay and deductible. The insurance company made the payments to the medical center where I was treated, and the OC (per the statement received from the CA) has a different name (Sunbeam, as stated in my first post). I would assume that Sunbeam is a contracted provider and the hospital handles their billing.

 

I do want to call out that my intention has never been to skirt the payment, just to try and rectify the collection and clean up the collection reporting if possible.

 

I feel like I'm so close, thank you for your help @Why Chat.

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@Why Chat Well that's the problem - I'm not absolutely sure but it would appear that they do have a business relationship. One thing to note is that the collection amount is slightly higher than the amount on the OC statement that they sent me by an strange amount ($77.02). The CA didn't provide a detailed statement on their end, just the OC statement.

 

Possibly worth noting, the OC statement had an online bill payment link and it shows the balance as $0, written off as bad debt.

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Pay using the HIPAA letter insert "a"as edited for your purpose

https://whychat.me/hipltr.html

 


Enclosed please find my remittance of ($___) for payment in full of this account.
This payment in full is for services as per the attached EOMB from my insurance provider

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 a violation of HIPAA Privacy Act rules and the Omnibus Final Rules. .
Copies of this correspondence and a copy of the remittance check may be used for any further actions with State or Federal agencies

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@Why Chat Interesting development. Today, via mail, I received a statement from the OC date May 16, 2020 with the amount that matched the CA amount. This statement also had the online bill payment link which shows the balance as written off as bad debt.

 

At this point, seems I should proceed with the HIPAA letter with insert "a" as you recommended and hope they take the appropriate steps to have the CA remove the collection from the CRA's, correct?

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@Why Chat Well the letter along with a cashiers check was sent to the PO Box on the statement received from the OC (payable only to the OC of course as detailed in the letter), and according to USPS the status has been "Available for Pickup" for over a week. I'm fighting the urge to just call the OC and ask what's going on, just being patient. I have the follow up letters ready to go once I can confirm the check has been deposited.

 

I'm guessing the COVID situation has had some impact on their day to day and maybe they don't have the staff to check PO boxes as frequently as they usually do, just seems like that would be problematic for their line of work.

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@Why Chat I guess I'm more impatient than I thought! What's my next move if they don't deposit the check? Called the bank today and confirmed it's still pending.

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