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Medical account fully paid but in collections


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Hello,

 

I'm in bit of an issue where a medical bill was fully paid, but the account is in collections. In an imperfect sequence of events, the insurance company briefly withdrew a previous payment and re-payed the provider. Meanwhile, the provider sent me the bill, went bankrupt and they are not reachable. Looks like they sold the debt to the CA and CA wants the money that was fully paid. I have the Explanation of Benefits and proof of the original payment. 

 

Feb 2019 to April 2019 - Service Provided by an in-network medical service provider for my child

May 2019 - Co-pay fully paid. Insurance fully paid. Account settled. 

Sep 2020 - Insurance withdrew the payment (mistake). Provider sends me the bill for around $1,200. I disputed it. 

Feb 2021 - Provider sends the account to the collection agency $1,200. CA sends me the letter. 

Mar 2021 - Provider closes the door. Unable to reach the provider. 

Apr 2021 - I sent the DV letter (after 30 days - on 39th day as I was traveling), used WhyChat DV letter. I got a vague response that I owe the money. 

Apr 2021 - Insurance re-payed the provider in full. They sent me the Explanation of Benefits which shows the account is fully settled.

Apr 2021 - Certified mail to the provider returns back (with HIPAA language), as the provider closes the door. Phone calls or emails not returned. 

Sep 2021 - CA keeps sending emails. Contacted the Insurance company. The Insurance company contacted the CA by phone and told them the account was settled. CA informs the insurance agent that it will contact the service provider and sort it out. 

Sep 2021 - CA reports to CRA. Credit scores drop. 

Sep 2021 - Online dispute raised with CRA with full proof of payment. However, all disputes closed that the debt is valid. 

Oct 2021 - CA sends me the letter I still owe $1,200 + interest. 


I have the payment proof (insurance payment + co-pay that was paid in 2019). Can I please get your advise? Would this constitute as an insurance fraud? Should I send the proof of payment to the CA? Thank you so much. Appreciate it. 

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You say you sent the DV letter from the HIPAA letter program to the CA??

 

Had you followed ALL the initial steps in the program??

https://whychat.me/GUIDEBOOK.html

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

 

You need to start from the beginning and follow ALL the steps if you want to get this off your reports. 

Begin by sending the initial dispute letter to the CRAs where the account is showing

https://whychat.me/hipaadisp.html

 

DO NOT communicate with the CA or call anyone or try to do this on line as you will sink deeper into trouble.

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Thanks Why Chat.

 

1. CA: The DV letter I sent to CA in Apr 2021 is not HIPAA. Just general verification - https://whychat.me/ltrcaval.html. They verified the debt with just the name of the provider but not the address.  

2. OC: Apr 2021 - I sent a letter to the OC but returned. That's the only HIPAA format I used was to OC medical provider (went bankrupt) along with the proof of payment but the certified mail returned. https://whychat.me/hipltr.html 

 

Given that I cannot contact the original medical provider to show my proof of payment, should I still continue with HIPAA program with CAhttps://whychat.me/ltrcavalhipaa.html#DISPUTE. Should I send the proof of payment to CA or ask them the contactable address of the OC? Thank you! 

 

Edited by felton1
clarity
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Thank you. Yes, the collections are reporting in all three CRAs. As advised, I'm sending them the dispute letter (step 1) tomorrow to all three CRAs. Will wait for the reponse from CRA and CA

 

How do you think I should proceed with Step 2 -- contacting the OC to send the proof of payment? OC is out-of-business since Feb 2021 and the letters to OC is returning back.

 

Thanks for your help. 

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Wait until you have a response from the CRAs before worrying about contacting the OC. Your problem is NOT with the OC but with the CA reporting incorrect data. 

 

There are follow up letters to the CA and to the CRAs in the program if needed, and as a last resort a complaint to the CFPB.

 

If it gets to that stage you would be sending your proof of payment to the CFPB

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  • 1 month later...

Hello, I have received response from all three CRAs stating that the disputed item has been deleted from the credit reports. I verified the reports and they are gone! I hope this is the end and no other follow-ups with OC or any other entity is necessary. 

 

Why Chat, Thank you so much for your guidance. Much appreciated. 

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