Author Topic: physician contracting svcs did not bill insurance, now sent us to collections  (Read 1925 times)

ssg2000

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Hi, I have a medical billing dilemma I am looking for direction on how to handle.  Not even sure where to start to resolve it.  We have some medical bills from a hospital visit for my husband earlier in the year.  We have received so many bills from so many different services from a 50 hour stay it is unbelievable.  We have been paying each of them off little by little each month.  Now we have been sent to collections for one company that is a physician's contracting service.  I called my insurance and they said this company has not submitted anything to them, I called the contracting service and they said they did not know we had insurance so they never billed them and now it doesn't matter we've been sent to collections.  I have many questions regarding this such as how does everyone else know and bill our insurance but this one group does not.  I have no issues paying off what we owe, but we also pay a lot for insurance and I want it utilized.  My biggest question is where to I start to get the proper amount send to my insurance company so we can start this over and handle it properly?  What is my recourse in terms of our credit now that this bill has been sitting out there and we thought insurance was handling it?  Any help or direction would be greatly appreciated......thanks, ssg

PMRNC

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    • One Stop Resources & Networking for Medical Billers
Sounds like there was some A/R factoring going on which IMHO should be illegal but it's not. That's when the doctors or hospital's "Sell" their A/R for pennies on the dollar to get rid of it, then the company that purchased them goes after the money, adding interest and finance charges to make a profit. Sounds crazy but it's not so unusual.  The hospital or the physicians office that generated the charges still has the legal obligation to provide an itemized billing statement, I would start by finding out who the charges were from, calling them, getting an itemized billing statement and then contacting your insurance carrier to see if they have paid their portion. If they have not then I would go ahead and write them a letter along with the itemized bill and submit it to them for consideration. You have a better shot with the insurance carrier than the physician or supplier, as the insured.  Anytime you get a hosp or medical bill where you decide to make a payment.. if the provider/hospital cash that check, that is considered a legally binding contract of payment. For example, if you have a $200 bill and you send in $20 towards that balance on the 15th of the month, and they cash that check, your payment obligation is $20 per month at that time of the month each month. Some hospitals and doctors WILL indeed send your check back with a counter offer, they won't cash the check and will send it back so that there is no legal obligation of taking that payment and so that they can legally submit to collection agencies where most times they have a better shot at collecting more.   The collection agency that has these charges right now your disputing still have a legal obligation to provide you with the original creditor (supplier) so you can obtain the correct billing statement and take it from there.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

SLITTLES

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There are a couple of possible reasons why they were not provided with your insurance information at the time of service and it happens sometimes.  The first thing I would do is provide them with my insurance information and have them submit the claim. 

Also just because your account has been sent to collections doesn't mean that it can't be reversed.  I would also dispute the balance with the collection agency and let them know that this was never filed to your insurance company; they can put your account on hold until this is done.

Hope this helps
Shontel Littles
" Show Me The Money"

ssg2000

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Thank you both.  I will try both approaches.  I will try to get them to submit to my insurance, if they do not then I will get the itemized bill and submit to my insurance myself and start chasing it this way.  I appreciate the feedback.