Insurance vent | Imamother

amother

Coffee

Fri, Jan 13 2017, 12:22 am

Abt 2 years ago I saw a specialist for a minor quick fix issue. Fast fwd abt 9 months and I get an angry call from the drs office that the visit wasn't covered and I should immediately submit a cc payment. I asked them to send me a bill ( which I got abt 2 months later) and I will try to submit it. What happened was that I had a good primary insurance through my fathers employment and a medicaid plan due to my financial eligibility. Generally works out very nice especially at hospital admissions like when I gave birth. She was yelling at me that she told me when I scheduled the appointment that they don't accept the primary. I explained to her that she didn't clarify that this would mean it wouldn't be covered by medicaid.( I had no clue that is what it means.) Anyway I spoke to a med. Rep and they said office should resubmit claim. In the interim they already sent it to collection agency cuz technically was a year from visit. Spoke again 2 med. Office again to Dr office about resubmitting and didn't hear from them in a very long time ( think was sometime in around may or June)
Got a call from coll. Agency again today. Called drs office again. Woman was extremely nasty and said u told Ruth ur sending a check (not true) I said we spoke abt it being taken care of by medicaid, ya they couldn't submit bec was past 3 months. I was literally dumbfounded. I only find out abt an issue 9 no after and now I have to pay this( plus coll agency fee) anyway tried begging her for sliding fee or s/tt. Nothing doing. I said I didn't even have an xray. Dr looked at my wrist and injected cortisone ( doubt he gets more then $75 from med.) So they dropped it like 50$. Now I only need to pay only $300... (That I don't have). Anyway will see if col. Agency will be a little workable but just needed to get this off my chest. Sorry for long post.

iluvy

Fri, Jan 13 2017, 12:44 am

I have had many insurance issues in the past and found that you can get very far by being aggressive. For example, "It's unfortunate that you didn't submit this claim in a timely manner, but since you didn't take care of it in time I don't see why this is my problem."

You are probably still legally liable. Doctors' offices make you sign a ton of stuff before they see you. But they are behaving very unfairly and will probably agree to settle for much less (e.g. what your insurance would pay them) if they see you are not going to make it easy for them.

I don't know how this works once this goes to collection, but it is very important to tell the collection agency that you are disputing this debt so that it doesn't ruin your credit. Once you tell them you are disputing it the burden is on them to get documentation.

iluvy

Fri, Jan 13 2017, 1:05 am

There is information about disputing a debt here: http://www.neweconomynyc.org/y.....debt/

Maybe I should have said assertive rather than aggressive. You are not being hostile and trying to make a stink, but you are calmly and from a position of strength outlining your position. Avoiding a chillul Hashem means behaving correctly and acting like a mentch, it doesn't mean making sure everyone likes you always. They are fed up with you for not divining their insurance policy, you are pointing out that you have made good-faith efforts to facilitate their being reimbursed and that everything would have been fine if they had 1) communicated better 2) taken care of this sooner.

doctorima

Fri, Jan 13 2017, 10:56 am

It definitely will take time, and only you can value your time. If you're prepared to pay $300 just to get them off your back, you have nothing to lose by calling up and telling them that you don't have the money, and they were negligent in their late billing, and it will take them months and cost them collection agency fees before they even see a penny, but if they're willing to send you a revised bill for e.g. $150 (decide something reasonable) and state clearly that this will be the full payment for the services and the balance will then be $0 (very important to get this in writing!), then you'll pay immediately and can both move on.

They may or may not agree, but you have nothing to lose, and even if they don't accept your $150, they may well counter with $200 or $250, so you've at least saved some money for just a 5 minute phone call.

33055

Fri, Jan 13 2017, 1:19 pm

iluvy wrote:

If you had Medicaid and they didn't bill, they can't collect. Medicaid has strict rules about this nonsense. I agree and get VERY aggressive and accuse them of not billing so they can get a bigger fee. They have to eat it because they didn't submit the claim. I would tie them up there. How dare they send it to collections when they are negligent! That is some nerve.