Debt collection threat from collection agency

[garyall]

What is the name of your state? This claim is made when I was living in Arizona, Now I am living in Minnesota.

Please let me know :

- Does it make difference, where I was living earlier from where the claim is demanded by collection agency....OR where I am living now (in another state)...?

- I got a letter from a collection agency of Phoenix (AZ) asking for a medical service payment, which was not paid by insurance company (which insurance company was tied up by my employer at that time, in 2004), While I have been told clearly by doctor that he would do only those treatments which were covered by insurance. Now if insurance has not paid them in full, they are asking me to pay the balance.

- What are my rights & options to deny that claim, I called the collection agency, but they said first to pay & then they will think...that person was not ready to listen the explanation & my communication/assurance given by the doctor.

Please guide me, I am new to this kind of communication from collection agency...what can I do...?

Thanks for your advise & help.

 

[moburkes]

No doctor can guarantee that your insurance company will pay for the treatments that you receive. It is YOUR job to verify with YOUR insurance company that the treatments that you want/need are covered. Generally, all treatments are clearly listed in your insurance policy.

You don't have to be in the same state in order to be responsible for the bills. If you received the treatment, and the insurance company did not cover some or all of it, then you are responsible for paying the doctor for their service.

 

[garyall]

Actually ,that doctor assured me that he will only charge to my insurance & I won't have to pay anything except co-pay... I paid that co-pay at that time. Now after few months they sent me this letter through collection agency , to pay the balance amount.

- This is totally wrong ,what I was promised by doctor during my visit , then after I was agreed to get treatment from him..I told him clearly that I would pay only co-pay otherwise I did not need that treatment from him & doctor promised me for the same.

- Also now, the collection agency sent me an form of agreement letter (showing some of my incorrect info...like as my SSN & signatures are wrong & not signed by me) in support of their claim to ask balance payment from me.... Can I dispute their proof/this copy of agreement etc...which is actually not signed by me & also has incorrect SSN etc...?

- What is the responsibility of my employer, as the insurance company was appointment by employer company...? Are not they responsible in it...?


Please let me know .

 

[moburkes]

The doctor cannot guarantee a payment by an insurance company. Period. It is your right and RESPONSIBILITY to make sure that you are covered. Period.

What part is confusing?

For example, what if you haven't satisfied your deductible, so your insurance hasn't kicked in? In that case, the insurance company wouldn't pay a DIME, although it is a covered treatment. That is YOUR responsibility, not the doctor's.

Your employer has nothing to do with the fact that you didn't verify coverage.

 

[garyall]

As I do not have any signed agreement...what collection agency is referring that is not signed by me....even then am i liable to pay...?

 

[moburkes]

As I do not have any signed agreement...what collection agency is referring that is not signed by me....even then am i liable to pay...?

I don't understand what you are trying to say. Please rewrite it. A signed agreement with whom?

 

[garyall]

I mean that I did NOT sign any such agreement with Doctor office, that if insurance is not paying them in full , they could charge me the balance...

Now without any such agreement , how that doctor office can force me to pay & send that demand through collection agency...when they do not have any such contract/agreement signed by me to pay such difference amount...

Please clarify now.

Thanks.

 

[moburkes]

Did you sign a HIPAA medical privacy form?

 

[justalayman]

I mean that I did NOT sign any such agreement with Doctor office, that if insurance is not paying them in full , they could charge me the balance...

Now without any such agreement , how that doctor office can force me to pay & send that demand through collection agency...when they do not have any such contract/agreement signed by me to pay such difference amount...

Please clarify now.

Thanks.

The fact you recieved services and do not have an agreement stating the docor will accept whatever the insurance company pays as payment in full is all the doc needs to sue you.

While I have been told clearly by doctor that he would do only those treatments which were covered by insurance.

You do not state whether the treatment was covered by insurance or not. I presume if the insurance company did pay some of the bill, then they were covered sevices. There was simpy a balance due from either a deductable not fulfilled or a service not covered 100% (other than the co-pay).

The thing you do not realize is you are responsible for the bill. PERIOD. The insurance company has no responsiblity to pay the doc other than within your policy and the doc has all legal and moral reasons to expect payment from you, regardless of the coverage you have.

If you can prove in court the agreement you claim to have with the doctor, you whould prevail but apparently the docs office does not believe there was any such agreement hence the bill and subsequent collections.

Through all your posts, you do not say anything about contacting the doctors office. Do you think there may be an error? If so, then you need to take care of it with the docs office.