Ground Ambulance Balance Billing In Collections (Not On Credit Report Yet)

[PeanutButterFalcon]

Hi All - I'm new here but I'll cut to the chase. I have an ambulance bill from 2021 which I've received a collections letter despite my insurance paying 50%. I'll provide some details below. I'll have some questions too.

 

Background Details / Additional Info

1. This was an emergency
2. Location: California
3. I reached my out-of-network out-of-pocket max and out-of-network deductible by the time this was billed
4. I have the EOB from my insurance for this bill
   1. There is a note on the bottom of my EOB which says:
      1. "HEALTH CARE PROFESSIONAL: THE PATIENT SHOULD NOT BE LIABLE IF YOU ACCEPT THE ALLOWABLE AMOUNT. CUSTOMER: CALL XXXXX AT THE NUMBER ON YOUR XXXXX ID CARD IF YOUR HEALTH CARE PROFESSIONAL BILLS YOU MORE THAN THE "WHAT I OWE" AMOUNT ON THE FRONT OF THIS EXPLANATION OF BENEFITS."
      2. Is this binding in any way?

 

Timeline

Mid-Late 2021

1. I was taken to the hospital/ER via ground ambulance (out-of-network) after a 911 call
2. After some time, I received a bill at some point for ~$2,000 (I can't remember when or how I got in touch with them for billing)
3. I sent the invoice to my insurance who made a partial payment; their was eventually a correction from the payments by my insurance to the ambulance service which resulted in my insurance paying an additional amount totaling 50% (treating them as if they were in-network and pay the "allowed amount")

 

May 2023

1. I received the first collections letter from Grant Mercantile Agency stating I have 30 days to dispute

 

May 30th, 2023

1. I called my insurance and mentioned that I have this collections item for this service which they had already paid and the insurance rep said don't pay them a dime, we'll call them and take care of it. I was amazed and confident it would get resolved, so I didn't send any type of dispute. Eventually the 30 days elapsed and I didn't hear from them, so....

 

First Week of July, 2023

1. I received a second letter from the collection agency. They said they want a letter of intent to pay or a payment plan setup. They can report this to the credit agency at any time.

 

July 8th, 2023

1. I called my insurance and made sure to speak with a supervisor. I followed up to find out the resolution, they said the ambulance service would not negotiate and that I had to pay the balance and they marked my claim/despite with their insurance company as "Resolved". It would remain in collections. She said that she would open one more dispute internally to see what more could be done. She said it would be 2-3 day and I'd be notified. I have not gotten an update yet.

 

July 14th, 2028

1. I spoke to my insurance again and they said that the negotiation that I opened with the supervisor is still on-going.

 

Where should I start? 

 

[MarvBear]

Welcome to CreditBoards.

[Why Chat]

https://lemberglaw.com/grant-mercantile-agency-gma-collections-complaints/

[PeanutButterFalcon]

13 hours ago, Why Chat said:

https://lemberglaw.com/grant-mercantile-agency-gma-collections-complaints/

Thank you! I have reached out to them. I'll post an update here for others once I have one.

 

Should I begin the WhyChat Medical dispute process only after it hits my credit report? Are there steps to take to resolve with the ambulance service? Any other suggestions?

[Why Chat]

I doubt it will hit your credit reports but if it does you can THEN use the dispute process

[PeanutButterFalcon]

31 minutes ago, Why Chat said:

I doubt it will hit your credit reports but if it does you can THEN use the dispute process

 

Unfortunately, the law firm was not able to help for my particular situation. They were very quick to respond though. Appreciate the recommendation none-the-less.

 

It looks like I'll wait and see what happens. I had several ambulance rides in 2021 and I've been stuck in a payment plan with American Medical Response (AMR) for over a year to pay off the balance bill that they said I owed after my insurance paid half. I'd rather not repeat that situation in addition to having a mark on my credit report.

 

I'll post an update if I have one but I'll keep my fingers crossed that your doubt about it hitting my credit report holds true. They did mention in their last letter that essentially that's what they have the power to do and will do it if they don't get some kind of payment or payment plan in order which is obviously worrisome and definitely their tactic.

[Why Chat]

Your prior payment arrangement with an OC (original creditor) has NO BEARING on your present situation. Given that it is with a CA (collection agency)  and NOT with the OC ambulance service their threat to sue is an empty one as they can NOT sue you, only the OC can do that.

[PeanutButterFalcon]

On 7/21/2023 at 4:04 PM, Why Chat said:

Your prior payment arrangement with an OC (original creditor) has NO BEARING on your present situation. Given that it is with a CA (collection agency)  and NOT with the OC ambulance service their threat to sue is an empty one as they can NOT sue you, only the OC can do that.

Great news - my insurance comapny came around after creating another claim, many, many calls and follow-ups of this claim. They made me work for it but they finally paid all of except for roughly $100, so I'm grateful.

 

I received a letter from the collection agency on 08/01/23 but my EOB from my insurance is dated 08/03/23.

 

How do I settle this with the ambulance company? Do I call them I tell them I'll pay the $100?

 

How do I get the collection agency to stop contacting me since they are not on my credit? Do I do this through letters only?

Need advice. Thank you!

Edited August 9 by PeanutButterFalcon
corrections and spacing

[Why Chat]

Pay the ambulance Co. with this letter which I have edited for your purpose.

Since I doubt VERY MUCH that the CA who contacted you was actually assigned the account by the OC I suggest you have NO further dealings or correspondence with them. If they call you tell them that you will be reporting them to the proper authorities for violations of the FCRA. If they mail you another "demand letter" do not respond.

https://whychat.me/GUIDE HIPAA PROGRAM.html  I suggest you follow the program and get your current reports.

 

(Your Name)
(address)
(City,State, zip)
s.s.# (social security #)
HIPAA Compliance Office
( health care provider creditor)
(address)
(date)
Dear Sir/Madam;
This letter is in reference to (account #) for services provided to (name of patient) on (date of service).
In regard to the bill on this account 
Enclosed please find my remittance of $100 for payment in full of this account.
This payment in full is for services as per the attached Explanation Of Medical Benefits from my insurance Co.
Please note, my remittance is payable ONLY to (hc provider) and may not be signed over or transferred to any third party collection agency

Your furnishing of my account information to (collection agency name), is not in compliance with HIPAA,   since there can be no permissible business purpose in divulging protected health information to anyone on an account once there is no longer any payment due. In addition the new Omnibus Final Rule states:when patients pay out of pocket in full, they can instruct their provider to refrain from sharing information.This letter serves as that instruction.

This simple procedure to request the deletion of ALL reference to this account from the records of ( collection agency name) will resolve this problem completely.

 

 

Sincerely,
signature
(Your Name)

[PeanutButterFalcon]

14 hours ago, Why Chat said:

Pay the ambulance Co. with this letter which I have edited for your purpose.

Since I doubt VERY MUCH that the CA who contacted you was actually assigned the account by the OC I suggest you have NO further dealings or correspondence with them. If they call you tell them that you will be reporting them to the proper authorities for violations of the FCRA. If they mail you another "demand letter" do not respond.

https://whychat.me/GUIDE HIPAA PROGRAM.html  I suggest you follow the program and get your current reports.

 

(Your Name)
(address)
(City,State, zip)
s.s.# (social security #)
HIPAA Compliance Office
( health care provider creditor)
(address)
(date)
Dear Sir/Madam;
This letter is in reference to (account #) for services provided to (name of patient) on (date of service).
In regard to the bill on this account 
Enclosed please find my remittance of $100 for payment in full of this account.
This payment in full is for services as per the attached Explanation Of Medical Benefits from my insurance Co.
Please note, my remittance is payable ONLY to (hc provider) and may not be signed over or transferred to any third party collection agency

Your furnishing of my account information to (collection agency name), is not in compliance with HIPAA,   since there can be no permissible business purpose in divulging protected health information to anyone on an account once there is no longer any payment due. In addition the new Omnibus Final Rule states:when patients pay out of pocket in full, they can instruct their provider to refrain from sharing information.This letter serves as that instruction.

This simple procedure to request the deletion of ALL reference to this account from the records of ( collection agency name) will resolve this problem completely.

 

 

Sincerely,
signature
(Your Name)

 

Thank you for this. It looks like GMA finally got added to my credit report and has been backdated to May 2023. I'll take the appropriate steps in the guide and what you've mentioned above. Thank you.

 

I'll follow up here for others to see things transpire and to be used as reference for others in the future. 

 

Take care.

[PeanutButterFalcon]

I followed up directly with Advantage Ambulance Billing department over the phone. I provided the EOB from my insurance via email to the woman that I was speaking to. They accepted that everything was in order and that my insurance actually paid everything that was owed.

 

She said she contacted GMA and mentioned the payments from Cigna and "notated" that my account be removed from collections. She said "I don't know if GMA charged you interest but that is something you will have to work out with them to have that waived"

 

All-in-all I'm very happy but the fact that they think I should owe GMA any money at all is absurd and they don't deserve a dime. Hopefully this is removed from my credit report very soon otherwise, I'll take the necessary steps to get it removed and make sure that GMA does not get any payment from me as the original creditor has been paid in full!

[PeanutButterFalcon]

On 8/22/2023 at 2:56 PM, PeanutButterFalcon said:

I followed up directly with Advantage Ambulance Billing department over the phone. I provided the EOB from my insurance via email to the woman that I was speaking to. They accepted that everything was in order and that my insurance actually paid everything that was owed.

 

She said she contacted GMA and mentioned the payments from Cigna and "notated" that my account be removed from collections. She said "I don't know if GMA charged you interest but that is something you will have to work out with them to have that waived"

 

All-in-all I'm very happy but the fact that they think I should owe GMA any money at all is absurd and they don't deserve a dime. Hopefully this is removed from my credit report very soon otherwise, I'll take the necessary steps to get it removed and make sure that GMA does not get any payment from me as the original creditor has been paid in full!

 

I received a phone call from GMA yesterday and they are still asking for payment which is almost laughable if it actually wasn't so angering. Despite having paid off the original creditor, the collection agency is still calling my phone and asking for payment.

 

Not only that, I rarely, and I mean almost never, pick up the phone from these debt collectors. But, this gentleman actually began divulging the ambulance debt and related details BEFORE I EVEN INDICATED AND AGREED THAT I WAS THE RIGHT PERSON THAT HE WAS TALKING TO! They clearly broke the law on that account and the fact that they are trying to collect despite Advantage Ambulance calling GMA and saying that I've already paid in full.

 

I'd love to sue these guys but I'm sure the chances of that are slim. For now, I'll work to just get it off my credit report.

[Why Chat]

If you do not get immediate deletion from the initial dispute letter to the CRA(s)

https://whychat.me/hipaadisp.html 

Is it reporting to all 3??

You can either use the follow up letters or jump to a complaint to the CFPB    https://whychat.me/hipaaftccomp.html

https://whychat.me/GUIDEBOOK.html

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

 

[PeanutButterFalcon]

1 hour ago, Why Chat said:

If you do not get immediate deletion from the initial dispute letter to the CRA(s)

https://whychat.me/hipaadisp.html 

Is it reporting to all 3??

You can either use the follow up letters or jump to a complaint to the CFPB    https://whychat.me/hipaaftccomp.html

https://whychat.me/GUIDEBOOK.html

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

 

Yes. It was reported to all three. It’s been a week since Advantage Ambulance spoke to GMA, so I won’t be wasting much time. I’ll check my reports tonight and see whether they are still there and then proceed with your recommendations, if necessary.
 

 

Thank you for being extremely responsive and providing relevant instructions to my situation.

 

Can we donate to your site somehow? I’m on my phone, so I’ll look around once I have my laptop and maybe I’ll answer my own question. Regardless, you rock!

[Why Chat]

If you scroll to the bottom of my website you will see a link for donations

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