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Guidance Please!

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I received a collections bill for $973.58 which is for two procedures I had- 6/1/18 and 1/25/19.  (I also had a third procedure on 10/18/18 that was not included in this bill.)

 

The first of the two procedures that is in collections was performed 6/1/18.  Cigna paid them 7/23/18 but they didn't add the contractual billing adjustment until 12/12/18.  The first bill I received for this was on 10/31/19, which is almost 1 1/2 years later.  The second of the two procedures was billed within 9 months. 

 

The third procedure (10/18/18) I had that isn't included in collections was also billed out approximately 1 1/2 years after the procedure date. 

 

I mailed a letter earlier in the week to the anesthesia group (prior to getting the collections letter) and told them to delete the two bills due to the timely billing law and to send me a new, itemized bill for the remainder of the balance that I do actually owe (part of the bill that's in collections).

 

Aside from the timely billing law, the collections letter has Best Choice Anesthesia but all of my bills are from Northwest Anesthesiology and Pain Services, PA.  According to a Google search, they used to be called Best Choice Anesthesia.

 

My question is, how should I dispute this?  Should I demand validation, claim no knowledge of creditor, timely billing law??

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Are these accounts on your credit reports?? 

Follow these guides;

https://whychat.me/GUIDEBOOK.html

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

 

If they ARE on your credit reports, send the CRAs this;

https://whychat.me/hipaadisp.html

 

Get your EOMBs from your insurance and send the following to the health care providers

https://whychat.me/hipltr.html ( follow the directions EXACTLY)

 

If your EOMBs show that you DO owe anything pay the health care provider with insert "a" and use this explanation;

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


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

 

If they are NOT on your credit reports you can omit the initial dispute letter

If your EOMB shows that you do not owe anyone anything use insert "b" as follows;

 

This account is a billing error.
(1)
It has been paid by my insurance copy of EOMB attached

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.

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They are not on my credit report.  I just got the letter today.  I guess where I'm a little confused is (1), the collection agency letter has a different company's name on it than what is on my bills (does this matter??) and (2) I just sent the letter to the original creditor a couple days before I got the letter from the collection agency demanding for those bills to be taken off due to the Timely Billing Law.  I know I owe a portion of it, which I will pay, but how should I proceed since the whole thing is in collections?  I didn't have time to get a response from the original creditor but they shouldn't be able to bill me for 1/2 of the balance that's with the collection agency because it took them so long to send the bill.  I do have the EOB so I could technically pay what the insurance says I owe even though I asked for an explanation of the charges in the letter that went to the creditor.

 

Do I now have to dispute the whole thing with the collection agency and reference the Timely Billing Law as to my reason I'm disputing 1/2 of the charges?

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Just follow the guides, opt out, get your PAPER credit reports.

PAY what the EOMB says you owe to the original creditor using the HIPAA letter insert "a" as shown.

 

You need to do this so the account will NOT be posted on your reports as a "paid" collection. You should not deal with the collection agency at all.

 

As to the bill not being "timely" that may be due to a delay in payment from your insurance or a sluggish inept billing office. You can't get a discount on medical services because they were slow to bill.

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Whychat,

 

This is what I have been told applies to Texas for the Timely Billing Law.  Was it not explained to me correctly that they can't bill me after the 1st day of the 11th month?  Does this just apply to them billing the insurance within 11 months?

 

§ 146.002.  Timely Billing Required


(a) Except as provided by Subsection (b) or (c), a health care service provider shall bill a patient or other responsible person for services provided to the patient not later than the first day of the 11th month after the date the services are provided.

(b) If the health care service provider is required or authorized to directly bill the issuer of a health benefit plan for services provided to a patient, the health care service provider shall bill the issuer of the plan not later than:

(1) the date required under any contract between the health care
service provider and the issuer of the health benefit plan; or

(2) if there is no contract between the health care service provider
and the issuer of the health benefit plan, the first day of the 11th
month after the date the services are provided.

(c) If the health care service provider is required or authorized to directly bill a third party payor operating under federal or state law, including Medicare and the state Medicaid program, the health care service provider shall bill the third party payor not later than:

(1) the date required under any contract between the health care
service provider and the third party payor or the date required by
federal regulation or state rule, as applicable; or

(2) if there is no contract between the health care service provider
and the third party payor and there is no applicable federal regulation
or state rule, the first day of the 11th month after the date the
services are provided.

(d) For purposes of this section, the date of billing is the date on which the health care service provider's bill is:

(1) mailed to the patient or responsible person, postage prepaid, at
the address of the patient or responsible person as shown on the health
care service provider's records; or

(2) mailed or otherwise submitted to the issuer of the health benefit
plan or third party payor as required by the health benefit plan or
third party payor.

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Yes, BUT-- look at your EOMB and see what date it was submitted to your insurance. THAT is the date covered under this § 146.002.  Timely Billing Required

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