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Lab didn't file with insurance on time, put it on my credit 2 years later.

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I would appreciate any help you folks can give me.  I had some lab work done and when the lab filed it with BCBS it got kicked back and I received a bill for it.  I emailed the lab to dispute the charges, and was told it had been filed with the wrong billing codes and that it would be refiled. I never heard another thing about it.

 

Almost 2 years later, the bill showed up on my credit reports as a collection.  After about a month of sending emails back and forth, I was told by the lab that the bill was submitted to the insurance company under the wrong BCBS policy number, so insurance refused to pay it.  This, of course, is contrary to them telling me it was initially filed with incorrect billing codes.  The lab never contacted me to try to get a correct policy number, never sent me a bill, never sent me a warning that it would go to collections.  Nothing.  Just two years later it's on my credit reports.  

 

Can someone please tell me the appropriate steps to take to get this collections removed?  The fact that they waited two years to drop this on me just boggles my mind.  BCBS has a 90-day timely filing requirement, so there's no way they can try to re-file it now.   Thanks!  

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Just to clarify, you're saying that they didn't initiate any direct collection activity after the bill had gone 90 - 180 days delinquent in their system?  Did you press on why they didn't take this timely action that would alert you that the balance hadn't been properly settled by your carrier?

 

Did you ask them why, after the matter had lain dormant for 2 years they then initiated collection activity?  (Did you receive notice of this in the mail?  Or was the first hint you had when the CA entered a tradeline into your CR?)

 

Did you ask them, having let this lay dormant for 2 years, such that your insurer will no longer accept a revised claim, why they think you have an obligation to them after their having showed no good faith in seeking recovery of their claim?

 

(And, if the answer is "yes" to the above questions, did you submit them to a senior associate or owner?)s

 

Finally, while I understand that insurers typically set a 18-mo time frame for initial submission of a claim, this claim was submitted (and rejected) well within the defined window ... it just wasn't resubmitted by your provider in a timely fashion.  Can you use this as prybar with the insurer to gain some cooperation in obtaining leeway to be permitted to resubmit the the claim now?  (In other words, given that you can detail how you exercised all reasonable care to submit the claim in a timely fashion, can they cut you a break so that you don't suffer from the lack of care on the part of your provider?)

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This post should be in the medical account forum.

In any case, follow the guides;

https://whychat.me/GUIDEBOOK.html

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

Send the initial dispute letter to the CRAs where the account is reporting;

https://whychat.me/hipaadisp.html

It is more than likely this dispute letter will get you a deletion, if not come back to this post (which should be moved to the medical forum) for further assistance.

As to why it showed up after 2 years-- it is more than likely that the reporting is being done by a JDB ( junk debt buyer) and not by anyone authorized to collect from the OC

Edited by Why Chat

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18 hours ago, hdporter said:

Just to clarify, you're saying that they didn't initiate any direct collection activity after the bill had gone 90 - 180 days delinquent in their system?  Did you press on why they didn't take this timely action that would alert you that the balance hadn't been properly settled by your carrier?

I have to tell you, it's been like pulling teeth to get answers from these people.  I emailed them about this on 9/11/20 and after much flat-out ignoring me and me hounding them, I just now got the response about them having the wrong policy number.  To clarify, after being told by email on 10/19/2019 that the bill had been submitted with wrong billing codes and that it would be resubmitted, I have heard nothing at all.  Not until the $925 bill just suddenly showed up on my credit reports.  I will send another email with this question if that is advised.

18 hours ago, hdporter said:

 

Did you ask them why, after the matter had lain dormant for 2 years they then initiated collection activity?  (Did you receive notice of this in the mail?  Or was the first hint you had when the CA entered a tradeline into your CR?)

The first hint was when it showed up as a collection on my credit reports.

18 hours ago, hdporter said:

 

Did you ask them, having let this lay dormant for 2 years, such that your insurer will no longer accept a revised claim, why they think you have an obligation to them after their having showed no good faith in seeking recovery of their claim?

I have not as yet, but will do so if that is advised.

18 hours ago, hdporter said:

 

(And, if the answer is "yes" to the above questions, did you submit them to a senior associate or owner?)s

 

Finally, while I understand that insurers typically set a 18-mo time frame for initial submission of a claim, this claim was submitted (and rejected) well within the defined window ... it just wasn't resubmitted by your provider in a timely fashion.  Can you use this as prybar with the insurer to gain some cooperation in obtaining leeway to be permitted to resubmit the the claim now?  (In other words, given that you can detail how you exercised all reasonable care to submit the claim in a timely fashion, can they cut you a break so that you don't suffer from the lack of care on the part of your provider?)

I can definitely detail all of my efforts.  Everything has been in writing by email from day one, which I still have.  And I am definitely suffering from a lack of care on the part of the provider.

 

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17 hours ago, Why Chat said:

This post should be in the medical account forum.

In any case, follow the guides;

https://whychat.me/GUIDEBOOK.html

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

Send the initial dispute letter to the CRAs where the account is reporting;

https://whychat.me/hipaadisp.html

It is more than likely this dispute letter will get you a deletion, if not come back to this post (which should be moved to the medical forum) for further assistance.

As to why it showed up after 2 years-- it is more than likely that the reporting is being done by a JDB ( junk debt buyer) and not by anyone authorized to collect from the OC

Thank your for this information.  I request that the board owner move my thread to the medical account forum.  Thank you!

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There is another question I should ask as I get started on this.

 

The collection agency put the account on my credit reports on September 10, 2020, but I first received a letter from them on October 6, 2020.  The letter warns me that I need to contact them within 30 days to dispute the debt or they will assume it is valid.

 

It will probably take at least 30 days, if not longer, for me to get a reply back from the credit bureaus to the Initial HIPAA Dispute Letter.  The HIPAA Program Guide instructs me to wait for these credit bureau results to determine whether or not I should send the Medical Dispute Validation Letter to the collection agency.  

 

I just want to make sure I won't get myself into a jam if I wait for the credit bureau results and don't send a letter to the collection agency within the 30 days they've given me in their letter.  Thank you.  

 

 

 

 

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CAs always lie like a rug. Requesting validation or disputing with the CA before disputing with the CRAs is NOT a good idea. Even IF the account is proven valid, you will still NOT be paying the CA. IF it is proven valid and IF the reporting CA is documented to be in a CURRENT business relationship with the OC you would then have the option of paying the OC directly via the HIPAA letter program.

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On 10/19/2020 at 11:57 AM, Why Chat said:

CAs always lie like a rug. Requesting validation or disputing with the CA before disputing with the CRAs is NOT a good idea. Even IF the account is proven valid, you will still NOT be paying the CA. IF it is proven valid and IF the reporting CA is documented to be in a CURRENT business relationship with the OC you would then have the option of paying the OC directly via the HIPAA letter program.

Thank you for this information.  It's appreciated! 

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California has a department of Managed Managed Health Care and they have worked wonders for me in similar situations. I would file this complaint with them  or similar agency in your state and they will most likely help you out or send you in a better direction. They are basically a witness in the process and they will punish the lab if they are doing something wrong, because they make money off the sanctions. They also have lawyers working there which is a better audience if you can get past the analyst, who are also very good considering how limited there time is.

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4 hours ago, tomuch said:

California has a department of Managed Managed Health Care and they have worked wonders for me in similar situations. I would file this complaint with them  or similar agency in your state and they will most likely help you out or send you in a better direction. They are basically a witness in the process and they will punish the lab if they are doing something wrong, because they make money off the sanctions. They also have lawyers working there which is a better audience if you can get past the analyst, who are also very good considering how limited there time is.

This is excellent advice especially if you live in CA

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On 11/7/2020 at 6:27 PM, tomuch said:

California has a department of Managed Managed Health Care and they have worked wonders for me in similar situations. I would file this complaint with them  or similar agency in your state and they will most likely help you out or send you in a better direction. They are basically a witness in the process and they will punish the lab if they are doing something wrong, because they make money off the sanctions. They also have lawyers working there which is a better audience if you can get past the analyst, who are also very good considering how limited there time is.

I live in Florida, but thanks for this suggestion.  I'll try to see if there is something similar here.

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