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Incorrect billing for medical services - advice needed

Discussion in 'Off The Beaten Track' started by mkats, Aug 26, 2013.

  1. mkats

    mkats Well-Known Member

    Hi FSU, I need some advice.

    This past weekend I got a letter in the mail from our university hospital (I'm a grad student) telling me that I owe them money for lab tests - that this is the final notice and that if I don't pay up within 15 days they're going to send it to a collection agency/adverse effect on my credit score, etc.

    Since I have zero recollection of having any lab tests done with them recently, I called to ask about it today. They're charging me for an EKG for atrial fibrillation done back in January - which, unless I developed amnesia, I did not have done. I told them this and the guy said they would "look into it" and couldn't give me any more information.

    It doesn't seem like a scam - the number I called was our university hospital billing agency, and they did confirm that this bill exists. How it got under my name, I don't know... and that's what's worrying me, since several classmates suggested that they would have had to have my social security number to bill me. The guy on the phone did verify my name, address, phone number, and date of birth. I know my name and information is in the system for previous visits but I did not have this procedure done. Is it as easy as punching in the wrong record number to accidentally bill the wrong person?

    Also weird - they said they've been sending me letters since June, but this is the first time I've gotten one.

    I've put up a fraud alert on my credit reports for the next 90 days. As of last time I checked my credit report (August 8) there was nothing abnormal.

    So my question is... the original letter (in all caps, very urgent sounding, mind you) informed that if it doesn't get paid off within 15 days then it will be send to a collection agency and would affect my credit score. The guy I talked to said that he would look into it but couldn't promise me anything as to when/if it would be taken care of. Several days have gone by already (weekend) and I'm worried about what would happen if they don't get it processed in time. I'm planning to keep calling the billing office until we get close to that deadline - but if it doesn't get taken care of (and I'm not that sure that it will, guy didn't sound so convincing), should I go ahead and pay it? It's $32 - not the end of the world. I would rather not pay for something I don't owe, but I'm thinking that might be easier than having to worry about removing incorrect reports on my credit score later.

    There was also a huge hullabaloo in the past few weeks about a breach of the university's electronic system, but I'm thinking that might not be related if they've been sending me letters since June.

    Help? I've never dealt with anything like this before so I'm awfully worried. Thanks!
  2. zaphyre14

    zaphyre14 Well-Known Member

    I would send them a registered letter stating your case and include copies of any paper records you have concerning the procedures you have had and the dates on which they occurred. Phone calls are fine but getting everything in writing is better.
  3. Oreo

    Oreo Well-Known Member

    I had a collection agency keep calling me for a medical bill I had nothing to do with. It turned out that the provider (who I was also a patient of) punched in my name by mistake. I was the one that had to get all over it though.
  4. my little pony

    my little pony war crawling into canada

    i was once sent to collections for an ER visit for someone with a similar name. and that person wasnt even delinquent in their payments. you may have to call several times to resolve it.
  5. mkats

    mkats Well-Known Member

    What happens if you get sent to collections? Is your credit affected right away or do you still have time to sort it out?
  6. my little pony

    my little pony war crawling into canada

    there should be time. if you cant tell from this thread, medical billing is frequently pretty half assed.
  7. Quintuple

    Quintuple papillon d'amour

    I'd say pay it and keep fighting for getting it right along with a refund. Reports to credit agencies are hard to undo (even if they send a request to remove the infraction, you know systems and human error will not get rid of all remnants). I was sent a final notice with a threat of being sent to collections because an appointment of mine wasn't coded correctly as "preventive care". I paid it, resolved it, got a refund. Not ideal, but better not to mess up your credit.

    But I'd be concerned about how it got billed to you in the first place. Can you go to them in person? Do you have a doctor in their system? Can the doctor's records show that she/he did not order any tests for you? Can they see that the results of the tests are not yours? If they think the results are yours, which poor patient is not getting the care he/she needs? Super annoying and time-wasting, I know.
  8. Aceon6

    Aceon6 Hit ball, find ball, hit it again.

    I'd go in person to the hospital billing office with my ID and the letter. Ask them to check all records of that "encounter". Chances are, the hospital visit for the A fib is on the right person, but the EKG isn't. Stand there while they fix it and have them give you a copy of your account showing $0 due.
  9. mkats

    mkats Well-Known Member

    I called the billing office again today. Apparently the guy from yesterday wasn't 100% brushing me off because as soon as I said the account number the lady today (who was much more helpful, always grateful for good customer service agents) said "Oh, you called yesterday, right?" She says there is a hold on the case and they are not going to send to collections and it is under review. They also agreed to call me rather than resort to old slowpoke snail mailing contact as they supposedly have for the last 8 months. She also reassured me that this happens "all the time" - not sure whether I'm supposed to find that reassuring or not-reassuring, but, well, anyway, moving on.

    I got the name of the doctor whose name was attached to this case and called his office. Here's where it gets weird... they had the EKG in question with all of my information (apparently he was just paid to read it - he's not the guy who ordered it) but nothing else. They told me that there wasn't even an ordering physician attached to it/an order. Somebody just sent the EKG over for him to read.

    I don't have a primary care doctor in this system. I know that my information is in the university hospital system because I'm enrolled a clinical trial and that each visit is considered a "hospital visit". However, I was not definitely in the hospital the date this EKG was done, and I'm sure there was no EKG attached to this study. I called the study coordinator to make sure I wasn't having amnesia. She confirmed they had nothing to do with it. I'm starting to think it was just a honest mistake where someone accidentally punched in my information rather than the actual patient's.

    Then, I'm thinking that if someone ordered an EKG, there should be at least a physician's note to go with having seen this patient. So next, I call the hospital floor where the EKG was supposedly done, and they confirm that there is no record of me having been a patient there. At this point I'm just glad somebody is backing up my memory, because I'm starting to wonder if I'm losing it. This lady was super sweet and even called the billing department for me to tell them that I was never admitted to their floor, but billing, being a pain in the ass, tells her we have to go through the EKG department. UGH.

    I call EKG. Lo and behold, the manager and only person who would know - is in a meeting, so I'll have to try back later.

    Thanks for all the advice and letting me rant :)
  10. backspin

    backspin Active Member

    Great job followiing up mkats!! Having been through the hospital/billing rigamarole this past year, I found there were literally DAYS I spent on the phone, going through bills, reconciling w/ insurance, etc. Good on you for tracking everything down. :)
  11. zaphyre14

    zaphyre14 Well-Known Member

    Good job in the persistence. Still, you might want to get all this in writing. If it does end up going to collections or getting on my your credit report, you won't want to go through all this again
  12. mkats

    mkats Well-Known Member

    Some updates (on my end, not so much on their end...)

    I got in touch with the EKG department manager, who seems to be a very sweet lady and willing to do whatever she can to help, although I'm not sure what she can do since now billing is claiming the EKG was done within the hospital and not within the "clinics" which is what I was originally told :duh: I know she's forwarded my case onto the powers that be and has promised to get back in touch with me when she hears something, along with instructing me to call her if I don't hear anything in a week. I have a direct number to her office and she actually answers the phone and returns messages. :lol: Love it when people are great at customer service.

    I've written letters both to the billing department and to the doctor that's billing me (not that any of this is really his fault, I kind of feel bad harassing him and his office) and those are in the mail.

    Two people from billing over phone have told me that the bill is on hold and will NOT be sent to collections; EKG manager lady has also put in a phone call to that effect, so I'm hoping that holds for now; again letters are in the mail so at least there will be evidence of our phone calls in writing.

    My program director suggested that I call the patient advocacy number for the university hospital. Did that this morning; nobody picked up so I left a message.

    I just feel like I have been a freaking lightning rod for bad luck this past week - mail order pharmacy screwed up my address and mailed my medications to the crazy ex-landlady, who was kind enough to throw them back in the mail since "you don't live here anymore" or just flat out stole them (personally my bet is on "stole them", but who knows, they're gone); pharmacy decides to confirm the re-shipment by not calling the number I left for them but instead calling my parents' number as the primary insured - and flat out tell my father I'm on birth control (thanks for the HIPAA violation and awkward conversation, Walgreens); the apartment complex somehow deleted(??) all of our information from their records and now we seem not to exist in their system, as we discovered when we tried to pay rent this month; and this. So many phone calls and missed classes for all of this nonsense! I told my boyfriend he'd better move out and get away from me before the roof caves in on him or something :lol:

    DEEP BREATH. I think I've done everything that I can for this stupid medical bill, and it's Friday and a long weekend, so I'm going to not think about it and enjoy the next three days, starting with an ice cream party this afternoon at this apartment complex that we supposedly don't live at. :rofl:

    Although, I will say that this experience gave me a new appreciation for what my patients must have to go through frequently :scream: and I'm very lucky to have my own health intact (I'm certainly luckier than the poor chap with afib who had to get this EKG...) and a supportive boyfriend. Life ain't so bad. ;)
  13. Quintuple

    Quintuple papillon d'amour

    mkats, woo woo, you're not the only one who's a lightning rod for bad luck. I hate when people say that, because it's not like your bad stuff goes away or it's equalized by others' bad luck, but you're not alone! You're alive, you've got support and a healthy perspective! I have to remind myself to think of Syria or the poor starving children of the world when I think of my very inconvenient but non-life-threatening issues.
  14. barbk

    barbk Well-Known Member

    It is not at all funny, but I'm amazed at the frequency with which the on-line pharmacies violate HIPAA while at the same time continually losing HIPAA authorizations for my husband to share his Rx info with me. Optum just left a message with our (now adult, and no longer even on our health insurance) daughter to let her know of a problem with her dad's prescription, despite having been told twice before that they need to delete her phone number and use our phone number instead.

    May I suggest you file a HIPAA complaint? http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html
  15. smileyskate

    smileyskate Active Member

    Yes, please file the HIPAA complaint. That is ridiculous. I wonder if anyone knows if you are entitled to any sort of damages as they gave your actual RX information to someone other than YOU (both sending it to the wrong address where someone else could get into it, and of course telling your parent what your RX is for-they should tell nothing at all about it. Not even the name of it.). I would be so upset. Who knows what people can do or gossip about with that info (I am sure in your case that won't be an issue but the point is still the same).
    Sorry to hear about your mess with the medical bill. I do hope whoever had that EKG was able to get their own results. You should not have to do all that calling and leg work. Someone from their end should have to do it and get back with you. Probably the message you left with the advocate should hopefully do the trick.
    Last edited: Sep 3, 2013
  16. julieann

    julieann Well-Known Member

    NEVER pay a bill for services you never received, they will blow you off for sure. I would stop with the letters and start visiting them in person, you may get more action. I would for sure file the HIPAA complaint.
  17. nikjil

    nikjil Well-Known Member

    Mail order pharmacies are the worst. You might want to check, several states have changed their laws and insurance companies can no longer require you to go through a mail-order pharmacy. I'm in the process of changing my prescriptions over after years of yelling at my mail-order pharmacy who makes constant errors but won't ever admit they're wrong.

    Billing errors of this type can take months to work out. The main thing is to stay on top of them, you want to be the squeaky wheel and keep your problem on the top of the their pile. Spent several months in the spring trying to work out a very simple coding error on a test I have annually, was so disgusted with this particular lab that I won't go there again for this test. I was particularly annoyed at the multitude of phone numbers I was given and the layers of bureaucracy that insulate the person who actually made the screw-up from ever having to deal with me. It was particularly annoying because I've have this problem before and specifically told the lab in advance to make a note about how it had to be coded so that my insurance would cover it.
  18. mkats

    mkats Well-Known Member

    YESSSSS - I just got a call from the billing department to tell me that it's been resolved, they're taking it off my account, and they'll be sending me a notice in the mail that states this.

    I think the evil threatening letter did the trick :slinkaway : as bad as I felt about sending it, it did get a specific person assigned to my case and this woman was fantastic in keeping on top of it, tracking down all the necessary people, and most importantly, actually believing me! It took another two weeks but it's finally done and over with. I made sure I got the name and email of her supervisor and as soon as I get that confirmation in the mail (fingers crossed) I'll be contacting her supervisor to tell her how awesome she is. :respec:

    Prescription has been transferred to a local CVS and it actually should not cost me more than mail order. I'd just used it for so long that I hadn't even thought about changing pharmacies, but this seals the deal - and I think I will be filing a HIPAA complaint.

    All in all, a great start to the weekend! Thanks FSU for all of your help and support! :cheer:
    Sassafras and (deleted member) like this.
  19. leesaleesa

    leesaleesa Active Member

    If you're insured, report it to your Insurer. They'll back off tout de suite if they know they can be charged with fraudulent billing. Don't take their word that it is resolved-Insist on a letter discharging the debt. Even if they put in writing, report them.

    A report is required when billing for an EKG. Call your insurance to see if they even billed for one, let alone submitted a report.
  20. nikjil

    nikjil Well-Known Member

    Congrats for getting it resolved! I went to fill my first prescription from the local pharmacy and discovered that I can get a 90-day supply only for pills I take once a day, anything that's twice a day I have to get from the mail order. I was bummed because this particular pill is fragile and the mail-order has sometimes broken around 1/3 of the pills. I called personnel who said they'd complain to the mail order about poor packaging.
  21. mkats

    mkats Well-Known Member

    The funny thing is... I was pretty sure that the hospital system never had my insurance information to start with. I double checked with them after seeing your post and they confirmed that it was just marked as "self pay, no insurance".

    The whole thing was just so bizarre, even the woman who finally took care of my case said she couldn't figure out why on earth I got charged for the reading of an EKG when I had clearly never been anywhere near the cardiology department.

    Two different people (I got another call this afternoon from someone else in billing to tell me it was resolved) have now promised me a letter to put all of this in writing. Since the case was only resolved late Friday afternoon I'm not surprised it hasn't showed up yet but you betcha I'll be right back on them if it doesn't show up this week.

    :duh: Sorry to hear you had to deal with that.

    I went with Medco for a number of years and always had good service. They were also relatively easy to deal with from the doctor's office end of things when I worked as an MA. Walgreens, on the other hand :scream: