Help needed from finance people

Submitted by Appropriate_Toe_2770 t3_ydexuc in Maine

I am victim of bad debt for a medical bill and have collectors calling me everyday about it. I called today to simply ask for a itemized receipt to see everything I am paying for an they refused - said it was a HIPAA violation and to contact my insurance company for a further look on a receipt. Does this sound right? How can a collectors agency demand money but have no clue what it’s for. If anybody can provide me with a solution for the next time I call - I would gladly appreciate it.

You think I am just gonna have to suck it up and pay this extremely inflated, nonsensical bill? Thanks

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Laeek t1_itrt78m wrote

>a itemized receipt to see everything I am paying for an they refused - said it was a HIPAA violation and to contact my insurance company for a further look on a receipt

This is correct. They're not the billing department of your healthcare provider, they're a debt collector. They have no idea what specific services you received that led to the debt, all they know is that it exists and that they own it. You should want your provider to not provide your medical history to a random 3rd party.

You can ask for proof of the debt (which is not necessarily an itemized list of costs) and verification that they are legally entitled to collect it. If they cannot provide that then they cannot collect. You can offer to settle for a lesser amount. You can ignore it and hope they don't bring you to court. Medical debt sometimes doesn't affect your credit rating as of this past July although I'm not up to speed on the specifics of that.

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Calliope719 t1_itsb1yn wrote

>You can offer to settle for a lesser amount.

Don't do this, or make any payments, until you've gotten proof you owe the debt. Starting payments can put you on the hook for the rest whether you owe it or not.

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Starboard_Pete t1_itsgo0b wrote

Seconding this. Years ago, my husband (driving a 12-year-old Prius) was in an accident with an $85k Audi. He was at fault, rear-ended the guy at a low speed during a rolling stop. Even though the Audi guy told him not to worry and that it was ok, he was ok, it was just a scratch, and drove off, he proceeded to claim that his car was near totaled and began repairs to try to get to replacement cost. He also claimed whiplash.

We got an itemized bill through the insurance company and found out he had his scratched Audi towed six times, and charged everything from a new bumper, new paint job, to new front windshield wipers towards the “totaling.” His insurance claimed a “ripple effect” meant all of these repairs were needed.

We refused to pay for 2.5 years, until the other party agreed to mediation, and whipped out the itemized bill immediately which reduced our “owed” debt astronomically. We settled at $12k-ish damage. Still a ton, but manageable. The alternative would have ruined us financially for good.

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Candygramformrmongo t1_itth0gm wrote

Did you not have insurance?

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Starboard_Pete t1_itu78ac wrote

We did, and they were pretty useless throughout the process, suggesting several times that we settle for a higher figure. We switched insurance companies afterward.

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Candygramformrmongo t1_ituyf1v wrote

I guess I don't understand. Your insurance should have provided coverage and paid this.

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gulfofmainah t1_itvj2gm wrote

I mean I’ve never had a honest experience with a auto insurance company they get really serious if your late to pay them but don’t mind at all making you wait for claims, it’s really one of the most corrupt rackets going.

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Appropriate_Toe_2770 OP t1_itstdo0 wrote

Thank you. You provided the answer by asking for proof of debt.

He threw an encounter date at me - would I then just act like it wasn’t me?

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78FANGIRL t1_its01vb wrote

You should have this information if you were billed for it and ignored them. Don't toss your bills. Pay them, or make a payment plan if you can't pay all at once. Ignoring the problem doesn't make it go away. I know people in debt collection. They're brutal and unrelenting. Everyone here is correct about the HIPAA regulations, I was in medical records before I stopped working. You don't want debt collectors with your medical information.

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odmcgirt t1_itu2rjy wrote

While the situation you are describing MAY have occurred - billing departments make mistakes.

The individual here may have had their bill mailed to the wrong address, may not have known to expect a bill because they incorrectly expected a service to be covered by insurance or the medical office could have miscoded something and the individual is now incorrectly receiving a bill for a service that was covered by their insurance.

No need for your lecture - our medical system is overly complicated, driven by profits and almost as morally corrupt as the insurance industry.

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jpGrind t1_itsicb2 wrote

sounds like a great question for /r/CRedit

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lazzerr11 t1_itsooen wrote

The healthcare organization has the itemized bill, go to them directly for those details. Insurance has an explanation of benefits (EOB) that tells you how much they paid of the bill the healthcare org sent to them with the remaining balance left for you. The EOB will not be itemized.

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odmcgirt t1_itu2txw wrote

If you want the calls to stop, tell them you want everything to be communicated in writing.

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nogzila t1_ituaywy wrote

You can ask where the debt originated from and then call that place to ask for the itemized bill.

On a positive note credit reporting doesn’t show medical bills anymore .

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Appropriate_Toe_2770 OP t1_itukr4d wrote

How true is this? I am not able to find much research to back this up.

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nogzila t1_ituu3fc wrote

https://www.cnbc.com/select/medical-debt-credit-report/

Medical debt almost didn’t count on a lot of things anyways before this .

This was for paid off medical debts but they are looking to eliminate medical debt from credit reports altogether as most people don’t take them into account in credit decisions anyways.

My father had 22k in medical debt and still bought a new car and house right before he died in 2017 .

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Appropriate_Toe_2770 OP t1_itv6bva wrote

It is how it should be. It’s not like I ran up my credit card traveling. I went into the ER because I had lost consciousness, was in the er for 6 hours and now I owe over $2500.

I don’t know how that doesn’t sound like health system is profit driven non-profit or not. Maybe a medical executive doesn’t need to make 300k a year.

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nogzila t1_itvdciz wrote

Most medical executives make millions a year sadly .

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Appropriate_Toe_2770 OP t1_itve65r wrote

Lol. Probably why my x-ray alone was $450! I will be battling this till the end thank you for your help. I advise everybody to fight and evaluate the crap out of these.

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Sleuthiestofsleuths t1_itrwfai wrote

This is correct. The collection agency can't provide itemized charges because they are not legally allowed to possess that information, due to hipaa. Soooo, you can challenge this debt with the credit agencies and the collection agency must remove it because they cannot prove you owe it. Write a letter to the big 3 credit agencies (I would send email + hard copy). You can find simple templates for this online. It's the rare loophole which actually works for the common man. Good luck!!

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Laeek t1_itryi7m wrote

>Soooo, you can challenge this debt with the credit agencies and the collection agency must remove it because they cannot prove you owe it

One simple trick to never have to pay medical bills! (Debt collectors hate this)

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Appropriate_Toe_2770 OP t1_itst4lg wrote

I am not going to lie that sounds like one of the smartest processes I have ever heard. One issue - would you actually risk letting (let’s just say) a $2,500 bill report? You don’t think they’ll have any tactics for that?

Because logically that actually sounds incredibly slick. As people have mentioned though, if they own they debt how couldn’t they prove I owe it?

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Sleuthiestofsleuths t1_itsveu3 wrote

Yes, the collection agency owns the debt. They buy it for pennies on the dollar and the hospital writes it off. So, no money that you pay will go to the hospital (this is different if it's a law firm collecting FOR the hospital.) If it's a collection agency, the hospital has written it off. If this collection agency can't collect, they'll sell it to another agency for even less than they paid. The MO of these agencies is to bully, threaten, and intimidate you into paying. Because of HIPAA they can't prove you owe it, but most people don't know that. And to answer your question about the $2,500 bill.....yes, I would and yes, I did. I have insurance and it was one of those things that I didn't even know wasn't paid until I got the nasty letter. I tried to pay the hospital but they wouldn't take it because it had been written off and turned over to collections. Therefore, I did not pay collections and I told them exactly what I told you. I know several people who have also dealt with this and, of those who were reported, every single one got it removed. This is one small corner of our very messed up healthcare system. We need to advocate for ourselves.

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Appropriate_Toe_2770 OP t1_itswwnj wrote

This is why I came here for this. You have an excellent way of thinking.

Should I specifically email the hospital to confirm it is written off? I do know in some instances a health care system will pay a cost to collect - right? Like they give up with a guarantor after a year (still want the revenue) but basically pay a collection agency to then call for the money everyday?

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Sleuthiestofsleuths t1_itsz80e wrote

I just did a little research and apparently, out of every 1,000 unpaid medical bills, a hospital will sue for an average of 1.73 of them. Fewer than 2 people per 1,000!! And they're not going to do it for a measly $2,500. You can confirm it's been written off, if you like. But just know that the hospital will verrrry likely never sue you and will not report to credit agencies. A collection agency cannot legally collect the debt if you challenge them, because they cannot prove it. If they should happen to report you, you can have it removed by challenging them with the credit agencies. Also, in case you didn't know - if you tell a collection agency to stop contacting you, they have to. As part of the Fair Debt Collection Practices Act, passed in 2021, you can send a letter to the collector telling them never to contact you again. Keep a copy of the letter. If they continue to contact you, you can sue them. You definitely have rights, so please use them!!

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wessex464 t1_itszm15 wrote

Sleuth is straight up not correct. Think about this for a second, do you really think there is some magical get out of medical debt free loophole? Of course not, that's absurd. Regardless of the experience he/she has had or a few friends have had, this isn't actually a thing. You may get lucky and the debt collector may not have the proper paperwork for the debt or you may irritate them enough that they stop bothering you, but they absolutely can and do verify these debts every day. It's worth a shot to ask(in writing) to verify it, but don't expect some magic "gotcha" to happen.

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Appropriate_Toe_2770 OP t1_itt59zc wrote

No but I do believe there is enough people willing to pay after getting called every single damn day, to keep an industry alive. I really do. While if you fight it long enough it’ll work in your favor.

Like sleuth said we need to advocate for ourselves in this “very messed up healthcare.”

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wessex464 t1_itt0142 wrote

That's not true at all. I don't know where you got that story, but its entirely not accurate. The hospital can easily verify that you were seen and what the bill is and it happens every day. You may have gotten lucky with an incompetent debt collector, but that doesn't mean everyone will have the same result.

Edit: Here's HHS saying the same thing:

https://www.hhs.gov/hipaa/for-professionals/faq/268/does-the-hipaa-privacy-rule-prevent-health-care-providers-from-using-debt-collection-agencies/index.html

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Sleuthiestofsleuths t1_itt0q1e wrote

Yes, of course the hospital can. But the hospital cannot share that information with any collection agency. Therefore, if the debt is challenged after it's been sold to collections, the agency cannot prove it's owed because they cannot tell you what it's for. Facts.

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wessex464 t1_itt147y wrote

Check my edit. HHS literally says that's not accurate. When you tell the debt collector to go verify it they can be provided with the minimally necessary information to validate the debt.

You got lucky with an incompetent debt collector, stop giving out garbage advice.

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Appropriate_Toe_2770 OP t1_itt8ppa wrote

Please don’t take this as me arguing just curious here. Minimum necessary requirements…. Ok… like? Encounter date? A revenue code to me sounds like it’s privacy.

Also how could we also confirm this is specific to guarantor billing

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wessex464 t1_itt9ggj wrote

You are providing some amount of consent when you ask them to go verify. You are telling them to minimally verify that the bill belongs to you, that's what asking them to validate the debt means and hospitals are explicitly allowed to share this information just like they do with your employer for workers comp issues, insurance agencies for payment, etc etc etc.

Health privacy is not some magic button that shuts everything off. The hospital isn't going to say they saw you for jock itch and nurse Esmeralda dingled your berries, but they absolutely can share that they saw you for a specialty exam, billing code 123, on date 12/12/12, they verified it was you, billed your insurance and that their records show you never paid the remaining balance. That's a verified debt for the purposes of proving that you owe money.

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Appropriate_Toe_2770 OP t1_itt9wxt wrote

I think the designated record set sums up everything you said. Thanks for providing that link.

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ANinjaForma t1_itrt7j7 wrote

Not an expert, but I believe collection agencies “buy” your debt from the medical or insurance company. So it’s not the same people/agency/company that provided the original service (ie the hospital).

It would make sense that the collection agency does not have your medical detail and you would need to talk to the insurance or medical facility.

It sucks. It feels like your being bullied and blinded at the same time.

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