Druff, your legal expetise is needed here...

[vegas1369]

I am going to try to make this as short as possible, not sure if I can do that though, but here we go.

In March of 2011 I cut my hand at home and required stitches...

Picture of injury...

 

I went to UMC quick care and got the work done, no problem. I was and still am fully insured for all medical. This was a simple copay of $20 and the rest to be taken care of by my insurance.

A couple of months later I receive a bill for this service from UMC in the amount of $716. I call UMC to find out why I am being billed and not my insurance. UMC says the claim was denied by my insurance.

I call my insurance to ask why it was denied. Insurance tells me that the doctor circled a part on the check in form stating this was a work related injury. I tell the insurance company this most certainly was not work related and that it happened at my home. Insurance tells me I have to call UMC and have them resubmit the claim as a non work related injury.

I call UMC and they tell me they will resubmit the claim, no problem.

Couple months go by and I receive a bill again from UMC for the same issue.

I call UMC and they tell me they are not sure what happened but will resubmit the claim again.

Couple months go by and I receive a bill again from UMC for the same issue.

I call UMC and they tell me they are not sure what happened but will resubmit the claim again.

Couple months go by and I receive a bill again from UMC for the same issue.

Now I am starting to get pissed. I call again, tell them I have called them about this issue several times, each time they tell me it will be taken care of but nothing happens.

This time the guy on the phone reassures me that it will be taken care of, but it might take a month or two for the billing to go through, so just ignore any bills that come in the near future.

Fine. Problem solved.

3 months go by and I am still receiving bills. Now I am getting concerned again. I call UMC, explain the whole situation AGAIN, I tell them I was told to ignore the bills but it seems like this should be all squared away by now.

UMC tells me they had submitted a new claim and it was denied and that I would have to contact my insurance and find out why it was denied.

I call the insurance company and they tell me it was never resubmitted. Obv someone is lying now. Insurance even gives me a claim number to give to UMC to expedite this process.

I call UMC again, explain the whole situation AGAIN, but this time ask to speak with a supervisor.

I speak with the supervisor who assures me this will be taken care of. Awesome. Finally some closure. This was June of this past year.

I haven't heard about this or received a bill since, so I finally assumed it was all taken care of.

WRONG!

I looked at my credit report the other day and low and behold there is a mark on it from a collection agency for this bill starting in August 2012. I never received any collection notice.

I call UMC last week to find out WTF is going on and have to explain this situation all over again. Obv they have notes on all my calls so they are somewhat up to speed on what is going on. UMC rep tells me they had sent this to collections in August. She then tells me in order to get this squared away I will need to contact my insurance and have them get on a 3 way conference call, me, insurance company and UMC rep. She tells me it was resubmitted back in June and was denied again.

I call my insurance company today to get the 3 way call going. Insurance company once again tells me that no claim other than the original claim back in March of 2011 was ever submitted.

3 way conference call is made. During that call I learn for a fact that UMC was lying to me the entire time and that they had never resubmitted the claim... Here is the reason why. In order for them to get it submitted as a non work related issue, they would need the doctor who originally did the work to resubmit a form saying it was non work related. Obviously they never did that.

Insurance rep says fine, all we need to do now is have you (UMC) send him an updated bill, which he can then send to us with a dispute saying it never happened at work and therefore should be paid as a non work related issue. UMC then says we cannot send him a current bill because it is in collections.

FUCK!!!

Insurance rep then tells me I need to get a copy of the collections bill from the collections agency, send that along with the last bill I received from UMC and a written dispute.

Fine. Now all I have to do is get the collections agency to send me a bill. Remember now, had I not checked my credit I would have never even known this was in collections. The collections agency never sent me a bill, never called... Nothing.

So here is where this story gets really good. I call the collections agency and request a bill. The collections agency then informs me THEY CAN'T SEND ME A BILL BECAUSE UMC GAVE THEM SPECIFIC INSTRUCTIONS TO NOT NOTIFY RECIPIENT!!!!

Let me repeat that. UMC sent this bill to collections but told the collections agency not to notify me. This is the most ludicrous bullshit I have ever encountered.

Collections agency girl was very helpful and told me I had to email her and state who I was and that I was requesting a copy of the bill, which I did. She verified receipt of the email and said she was sending out a copy of the bill.

I then called the insurance company and filed a complaint against UMC. They were not sure if I have any legal recourse through this, but told me to contact a lawyer.

I chose to contact you first and get your opinion.

Thoughts?

[vegas1369]

Damnit... "expetise"...lol

[Steve-O]

You have to keep contacting them until you get someone who will help you. The important part is to get it done through the hospital you went to as the code needs to be changed on the billing. A similar thing happened to my wife (she went in for an insurance covered follow-up to a procedure she had done that is normally done in cases where people are looking at invitro fertilization, which is normally not covered, so the medical biller at the hospital coded it wrong) and we had a bill for like $2,600. It took about six months and a dozen phone calls to get it straightened out. My advice is to keep calling the billing department at the hospital until you get someone friendly.

[NaturalBornHustler]

Hospitals are notorious for doing this, when I did mortgages you would not believe how many times a bullshit collection that had to be cleared up was medical. Hospitals are desperate for cash, and will try any way they can to get more money out of someone.
They will usually overcharge the shit out of you, to get more money than insurance is willing pay on a similar claim.

They are banking on people getting into a situation (like trying to take out a mortgage), not have the time to deal with it and just pay it off and try to recoup the costs later. Then they are banking on them forgetting about it and dropping the issue. Small amounts under $500 or so are perfect for this. Many times people think that it is just a mistake that can be cleared up easily, not realizing the hoops you have to jump through to resolve the issue.

Health care system is so fucked.

[RichardBrodiesCombover.]

I don't have any advice to offer other than getting a lawyer.

That cut looked pretty deep, how did it happen?

[The_PHA]

You are totally fucked. You cannot get around the credit agencies. Are you going to spend another year trying to get this off your record? If its the only thing on your credit history you can explain it away if you are trying to get a loan or something. If there is some type of pattern, you'd be looked upon as a deadbeat.

Not sure what advice you are looking for. You are in the collections system and you are no longer a customer of the insurance agency. Basically your file is on the desk of 408Mike, or the equivalent. Whatever window you had to settle has long since passed. You likely will get phone calls weekly unless you pay or change your number.

[vegas1369]

I think you guys are missing the point of the OP, which is completely understandable considering how long and hard it is to follow. My main question is do I have any recourse with these assholes (UMC) giving me the runaround for over a year, then turning this over to a collections agency and telling the collections agency NOT TO CONTACT ME.

The only reason I found out about this was because I checked my credit report. Had I not done that this could have gone on for God only knows how long. Possibly years.

Cliffs are..

-Injured hand.

-Got stitches at UMC.

-UMC doctor marks it down as a work related injury, but the injury happened at home and was not work related.

-Insurance denies claim because it was marked down as work related and therefore should be a workman's comp issue.

-UMC claims multiple times over the course of a year and a half that they will resubmit the claim as a non work related injury, but they never did and continued to send out bills to me.

-UMC sends the bill to collections and gives specific orders to the collections agency NOT TO CONTACT RECIPIENT.


Let me repeat that one more time. They sent the bill to collections and told the collections agency not to contact me. What the fuck is the point of sending a bill to collections with the intent of never allowing the collections agency to collect the money. I see this as malicious behavior. There can be no other reason to do this other than to get the bill off of their books and cover up their mistakes. They need to pay.


RBC, the cut happened on a broken glass bottle.

[The_PHA]

What the fuck? You are much smarter than this.

You have no recourse and you know it. You are the customer of a collection agency now. I assume if your debt was larger, say $7,000 instead of $700 it might peak the interest of some Insurance intern. But $700? Not on the radar of ANY insurance agency.

So you are now in the abyss of collection agency leeches. You can either pay or change your phone number.

I am going to be candid, but you probably felted enough the last 10 years in the bar industry to cover this easily. You win some, you lose some, you lost on this one. Pay or change your phone number, its that simple. Sucks, but its part of life.

[RichardBrodiesCombover.]

Is the collection agency a subsidiary of UMC? If it's a third party collection agency it may make the situation more difficult to rectify.

[vegas1369]

What the fuck? You are much smarter than this.

You have no recourse and you know it. You are the customer of a collection agency now. I assume if your debt was larger, say $7,000 instead of $700 it might peak the interest of some Insurance intern. But $700? Not on the radar of ANY insurance agency.

So you are now in the abyss of collection agency leeches. You can either pay or change your phone number.

I am going to be candid, but you probably felted enough the last 10 years in the bar industry to cover this easily. You win some, you lose some, you lost on this one. Pay or change your phone number, its that simple. Sucks, but its part of life.

I appreciate the response, but you are completely missing the point.

This is not about the collections agency, I am not worried about the collections agency at this point.

This is a very important aspect of this so let me make this very clear, and please let it sink in. I had to get a bill sent to me from the collections agency today, which I then have to send to my insurance company with a written disputed letter. My insurance company is very helpful in all of this, and I actually have a personal rep there that is handling all of this on their end. Once I receive the letter from the collections agency (which was sent out today) and send it over to my insurance with the dispute letter the bill will be paid in full. I have been assured of this by my insurance company and I fully trust they will do so.

The legal issue I am asking Druff about is whether or not I have any recourse in how UMC has been completely incompetent in the handling of this and then engaging in a practice of sending a bill to collections and specifically telling the collections agency to NOT CONTACT ME, thus damaging my credit. All the while they led me to believe this was taken care of. Meanwhile they went behind my back and sent the bill to collections and told the collections agency to not notify me knowing every month it would be marked off as a unpaid bill to a collections agency on my credit report.

[vegas1369]

Is the collection agency a subsidiary of UMC? If it's a third party collection agency it may make the situation more difficult to rectify.

It's a third party collections agency. That's a whole other ball of wax I haven't even gotten to yet. UMC assured me today on the phone that once they are paid through my insurance company they will have the collections agency issue on my credit report completely wiped off. At this point I am cautiously optimistic but have no reason to trust them.

Main issue right now is getting the insurance company to pay, which after today shouldn't be a problem. I'll deal with getting it wiped off the credit report after that.

What a giant clusterfuck.

[The_PHA]

What the fuck? You are much smarter than this.

You have no recourse and you know it. You are the customer of a collection agency now. I assume if your debt was larger, say $7,000 instead of $700 it might peak the interest of some Insurance intern. But $700? Not on the radar of ANY insurance agency.

So you are now in the abyss of collection agency leeches. You can either pay or change your phone number.

I am going to be candid, but you probably felted enough the last 10 years in the bar industry to cover this easily. You win some, you lose some, you lost on this one. Pay or change your phone number, its that simple. Sucks, but its part of life.

I appreciate the response, but you are completely missing the point.

This is not about the collections agency, I am not worried about the collections agency at this point.

This is a very important aspect of this so let me make this very clear, and please let it sink in. I had to get a bill sent to me from the collections agency today, which I then have to send to my insurance company with a written disputed letter. My insurance company is very helpful in all of this, and I actually have a personal rep there that is handling all of this on their end. Once I receive the letter from the collections agency (which was sent out today) and send it over to my insurance with the dispute letter the bill will be paid in full. I have been assured of this by my insurance company and I fully trust they will do so.

The legal issue I am asking Druff about is whether or not I have any recourse in how UMC has been completely incompetent in the handling of this and then engaging in a practice of sending a bill to collections and specifically telling the collections agency to NOT CONTACT ME, thus damaging my credit. All the while they led me to believe this was taken care of. Meanwhile they went behind my back and sent the bill to collections and told the collections agency to not notify me knowing every month it would be marked off as a unpaid bill to a collections agency on my credit report.

I am not sure what you are not letting sink in.

Druff is a good guy and has good advice, but even he cannot fight the Insurance bureaucracy. There is probably a 10% chance this will NOT end up on your credit unless you pay. And even if it was, exactly what are you lobbying about? Are you serious? $700 has you this worked up, and lets assume it was $7,000, what exactly would you do about it? I get the class action lawsuit thing, but this is downright silly

[Dan Druff]

First off, this is a disaster, but not a bit surprising.

I had a similar (but not as bad) issue with a hospital in 2008 involving a miscoded CAT scan, where they wrongly insisted I owed $3800. It was very hard to get fixed.

I need to understand what you are asking.

Are you asking how to get this off your credit? Because once this is cleared up, you can write to the credit agency and have it removed (make sure to supply all of the proof indicating this was an error on UMC's part).

If you're asking if you can sue UMC about this, you can't. You have no damages other than inconvenience. You could only sue them if they were uncooperative and refused to provide documentation that would allow you to fix your credit.

[Hurdleking]

Vegas, shortish answer is yes you have a theoretical claim against the hospital but since the insurance company is going to take care of it your damages are essentially de minimus.....unless you can show real damage as a result of your credit being adversely tagged it is likely not worth the salt......if you can find some kind of consumer based statute that gives you a bump in damages it prolly isnt worth your time or aggravation...hth

[vegas1369]

First off, this is a disaster, but not a bit surprising.

I had a similar (but not as bad) issue with a hospital in 2008 involving a miscoded CAT scan, where they wrongly insisted I owed $3800. It was very hard to get fixed.

I need to understand what you are asking.

Are you asking how to get this off your credit? Because once this is cleared up, you can write to the credit agency and have it removed (make sure to supply all of the proof indicating this was an error on UMC's part).

If you're asking if you can sue UMC about this, you can't. You have no damages other than inconvenience. You could only sue them if they were uncooperative and refused to provide documentation that would allow you to fix your credit.

I was asking question number 2. After I wrote my last post to PFA though, I stepped back and realized he is right in that there is no chance of any sort of legal repercussions towards UMC. Wishful angry thinking on my part. I spent the better part of 3 hours on the phone today with this bullshit. Brutal.

[vegas1369]

Vegas, shortish answer is yes you have a theoretical claim against the hospital but since the insurance company is going to take care of it your damages are essentially de minimus.....unless you can show real damage as a result of your credit being adversely tagged it is likely not worth the salt......if you can find some kind of consumer based statute that gives you a bump in damages it prolly isnt worth your time or aggravation...hth

Pretty much what I figured. Thank you.

[The_PHA]

Vegas, shortish answer is yes you have a theoretical claim against the hospital but since the insurance company is going to take care of it your damages are essentially de minimus.....unless you can show real damage as a result of your credit being adversely tagged it is likely not worth the salt......if you can find some kind of consumer based statute that gives you a bump in damages it prolly isnt worth your time or aggravation...hth

Pretty much what I figured. Thank you.

Basically my original advice 100%

Do not doubt me. Ever.

[Lannister]

Pretty much what I figured. Thank you.

Basically my original advice 100%

Do not doubt me. Ever.

You told him to pay the amount you stupid fuck. It isn't even close to your original advice.

Also, stop acting like losing $700 wouldn't cripple you in real life. You are very poor and it would hurt you financially to lose $700.

[offthetop]

Only in america....

[gut]

1 thing that is confusing to me is the third-party collection agency. I thought all 3rd-party agencies bought unpaid debt for pennies on the dollar, and played the numbers game hoping that 1 out of 10, 20, whatever will pay and then they at least break even. I don't see how they would buy, or "take over a debt" while agreeing to not contact you.

When i first read your story I assumed the collection agency was simply a part of that medical company. Are you sure it's a 3rd party?