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Medical billing practices can make you SICK!
I have had it with the way people who handle billing for hospitals and doctors operate. The Mountain Star Hospital chain billing department is one of the most frustrating group of humans on earth! In April of 2008 i had to go to the er because of severe abdominal pain. I paid my required insurance copay, was treated and then sent home. My abdominal pain was much better, but what i didn't know is my real pain had just begun! A few weeks passed and i received my insurance explanation of benefits or eob and the whole er bill, including the doctor was 100% covered except for my 100$ copay, that i paid the day of my treatment. "Patient responsibility"...zero! That is where the ordeal should have ended...SHOULD HAVE! Well about six months went by and i received a call,the first of many...from MountainLand Collections. The billing department for the er doctor i saw sent an account to mountainland to collect 283$ for his services. I had my eob that said they were paid in full, and i owed them nothing for that date of service. I told them the claim number and the date that the insurance had paid it, less than 30 days after i was released. MLC said they would contact their client...the er doctor...and have them recall the account because the insurance had paid it. Before hanging up they said,"we have to let you know this is an attempt to collect a debt!" Ok, fine thanks. Thinking,"OK, the insurance paid this account and i had given mlc the information that they needed to fix this, its done." NOT!!! More time goes by, quite a bit actually, and i had taken care of it, it was paid. HA! All of a sudden out of the blue mlc calls me. I knew that April account had been paid and they had proof, so maybe they had another account i didn't know about. "what is the date of service and who is it from," i asked. April 2008 er physicians...the same date of service they were supposed to clear! Once again i told them the insurance had paid it, i owed nothing...please fix this. They said they would pass the information on to the client again and "this is an attempt to collect a debt". More time goes by, i didn't even think about this account anymore, after all it had been paid by the insurance and i owed nothing and they had proof! Ring Ring Ring...guess who! mlc! I didn't feel like dealing with them, at this point i also knew i didn't owe them anything, so i didn't answer the phone. they called my house twice a day for a few days and i ignored them so what do they do next? THEY CALL MY HUSBANDS WORK PHONE! They told him that this account was going to go to their lawyer and if we didn't pay that very day, they would take us to court, "this is an attempt to collect a debt." This made hubby very "upset". Hubby calls me...you need to call this person and take care of it, they are going to sue us. I told hubby, "bill has been paid by the insurance, we owe them nothing, and i will call them. I will also inform them that they are not allowed to call him at work, and they better not do it again." I called mlc, told them not to call hubby's work phone anymore, and we owe nothing on this account, insurance had paid it and they knew that." "OK, we will not call his work phone, and we will verify the account was paid by the insurance", oh and,"this is an attempt to collect a debt". More time goes on...i am thinking,"finally they will fix this mess." NOPE! They call again! Same date stupid account! This is retarded! I called the insurance company thinking if mlc gets a call from the insurance company, and they tell mlc that the bill was paid and i owe nothing, that it would be resolved. Strait from the horses mouth so to speak! They would have to believe and insurance company...RIGHT? The insurance company calls me back. "We have told mlc that we have indeed paid this claim, and they should not contact me in anyway. Mlc said they would hold off for sixty days, for that is how much time they needed to get everything squared away. Sixty days later, mlc calls again, my husbands work phone! Hubby very upset again, after all they were threatening to take us to court, had to pay this bill now or they will tack on lawyer fees, and the amount could double. Hubby calls me, i reassured him, that it was still the same account that they had been pestering us for for months and that the insurance had paid it and we owed them nothing i would call mlc again and take care of it. I called mlc...AGAIN..went through the whole, "we don't owe this the insurance has paid it don't call my husband at work again!" "Your insurance denied this claim and you need to pay us NOW!". I told them I would call the insurance and see why they denied the claim, confused as to why the insurance had sent me an eob showing my financial responsibility was zero. "OK, and we have to let you know that this is an attempt to collect a debt" Fine. I called the insurance again to see why they sent a denial letter to mlc for an account they had paid over a year ago. "it was denied due to the fact that it was a DUPLICATE claim and had already been paid. Evidently the er physicians had sent the insurance another bill instead of sending ME a letter informing me that they had cleared the account. The insurance was not going to pay the same claim again! At this point the insurance claims adjuster suggested she and i make a conference call to mlc and the er physicians billing department and tell them this bill had been paid, i owe nothing, and to leave me alone! We arranged to do the conference call the next day. I got all of my documents in order so i would have the information in front of me when we made the call and a copy of the original bill from the er with the number of the people we needed to talk to. The claims adjuster for the insurance called me and i gave her the numbers for the other two party's. mlc was easy to get on the line, but we got transferred several times until we finally got a person from the er docs billing department that could fix things. While mlc the insurance and the doc billing were all on the line, the adjuster informed them that she had copies of the canceled checks that the er physicians had cashed, a month after the date of service and i owed nothing, never owed anything, and would not owe anything in the future. She told the er docs to clear the account, and mlc to leave me alone! They said they would, and i would have a letter in thirty days stating the account was cleared and my credit repaired. mlc and the er docs hung up and the adjuster said that should do it...end of story. WHEW! Its over! WRONG AGAIN! Two years after the date of service, and remember they cashed the insurance check in the same month as the date of service, and guess who calls me. YUP MLC!!! They were still demanding payment for this same stupid account! The agent at mlc was new to this case so i had to tell her the whole messy story and that it had been paid, i owe nothing, and that this was supposed to have been cleared months ago. She said that,"the insurance had denied the claim and i had to pay it right away, it was a two year old account and they were going to take me to court now because it had not been paid." I informed her it had been paid, and this account should have been resolved months ago! She told me i would have to mail or fax her a copy of the eob as proof it had been paid and as soon as she got it she would clear the account. I told her i would have the insurance fax her copies of the eob that day. Before hanging up i got the old, "This has been an attempt to collect a debt" speech. I was beyond annoyed now! I called the insurance...again...they said they would fax them right then and there the eob and that should take care of it! "Good, lets hope so, Thank you", i said. I called mlc back and told them they should be receiving the fax within the hour from the insurance. mlc said," OK, they would clear the account after the fax came in, and would send my cleared account confirmation letter to me in a couple of weeks. and this has been an attempt to collect a debt". Great, fine, dandy! six days go by. On Friday Feb 26th all be darned if i didn't get a letter from mlc. With happy anticipation,for i was expecting a letter stating my account was cleared and my credit repaired, i opened the letter. "This account is very old and is being sent to our law department. You can pay this off to avoid legal fees by calling this number and asking for extension 215 to make a payment." Date of service, april 2008, provider, the er doc, the date on the letter? Two days after the eob had been faxed to them from the insurance! And at the bottom of the letter in BIG BOLD PRINT..."THIS IS AN ATTEMPT TO COLLECT A DEBT" NO WAY! You have got to be freeking kidding me! I called the number on the letter, dialed in the extension 215, and a recording proceeds to tell my that the extension does not exist! I hung up and called mlc again and asked for the agent listed on the letter. "She isnt in the office today, we will take a message and have her call you." "I don't think so, i want to talk to someone right now!", "we are sorry you have to wait and talk to her, she is the only one that can deal with this account." "OK, take a message and have her call me asap, this account was supposed to have been cleared six days ago." "this is an attempt to collect a debt" goodbye. I was at my wits end...i wasn't about to wait for her to call me, i called the insurance again. "remember that claim we took care of last week? well they sent my letter, not a paid in full letter, a give us 289$ now letter!" The insurance person is now as frustrated as i am. "Give me their phone number and i will call them". i gave her the number and let her know that the agent they said had to handle the account was out of the office and she was the only person that could. "I will make them talk to ME TODAY even if i have to keep going over someones head till i get to the president of the company. I will call you right back". I thanked her and didn't expect for her to get anywhere either. 20 minutes later the insurance company called me. "Mrs. Olsen, i demanded they take care of this today, i am faxing a copy of the canceled checks and have told them that they had better clear this and mail you the RIGHT letter next week at the latest!" I asked her how she did that, after all i had been told they couldn't help me until the agent over my account came in the next day. "I kept asking for supervisors of supervisors until i got someone in charge. We have been dealing with this long enough, They have one week to clear it...I would suggest you file a complaint with the better business bureau and maybe look into filing a harassment claim against them." I am seriously considering this, the insurance company would give me notarized statements supporting my case. My mom thinks i should, "get Ghepard" a local news person that goes to bat on camera and makes people do their job. I would love to do that, but i DON'T want to be on TV! We shall see if this nightmare is finally over...i am not going to hold my breath! Keep your fingers crossed, and if anyone has had similar problems, please let me know. I would also be glad to tell you the names of the players involved so you can avoid these jerks! i will let you know how this saga turns out!
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4 comments:
Here is an update, it is Thursday March 4th, and still no contact or letter of resolution from mountainland collections. I'm probably going to have to seek legal advice, anyone know a good lawyer?
okay, still no word from mlc or the insurance. I am going to send an email to Mr. Gephard. i hope; he can fix this and make them send me my letter! he is awsome that way! wish me luck!
Oh My Gosh Janene.... this is soooo ridiculous, you must be "beyond" pulling your hair out!! I've had a couple of similar "problems" before, one with the hospital (the er & er doctor), but not to the extent of your issues. We went to the er one night, they checked us in, asked for insurance card, etc. Same as you, eob said er visit was covered at 100%, but nothing was paid to the er doc. because none of our hospital's er doctors contract with insurance companies. But, no one mentioned that upon "check-in"....grrrr
Then, the other issue was with a bank/mortgage company, we had acquired some more property next to ours that needed to be added to our legal description, sent them $130 to write up the description into the loan. They never got it done, then sold my mortgage to a new company, and in order to have the new co. write it in I would have to pay all over again.... Ha... I say B.S.!! It was a battle, and I earned every bit of that $130 back, but learned a little education along the way. Banking instutions are governed by a "watchdog" called the OCC (Office of Comptroller of Currency).... anyway, like you I had all documentation, letters, phone calls, names and wrote my story... about paying for a service I didn't receive, therefore I want a refund in 30 days or this is what I am sending to the OCC along with a formal complaint against your institution. In 30 days FedEx drove in my driveway with a check, that I signed for... :)
Hang in there... after a while it becomes the principle... Good Luck!!
Thanks Joan! It isnt even the principle at this point. I am not going to give the idiots a single red cent! I dont owe them a thing! Here is an update...still not a single word or letter or anything yet...and Mr. Gephardt....no answer...omg!!!!!!!
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