Dear Melissa
I have a son who was hit by a car while riding his bike 10/07. He had to have surgery to fix a very badly torn ACL. The establishment where he went to have his surgery for the repairs insisted that we use our own insurance for them to bill. We gave them the insurance information and was expecting it to be billed to our own medical insurances until the third party payer paid a settlement, but instead, my son got turned into collections after only 45 days… and they didn’t even bill our insurance companies, one of which (I had informed them before they turn him into collections) had set up a subrogation claim. After calling the establishment that did his surgery and informing them that I knew that they had not billed a claim to an insurance company that THEY are contracted with, the establishment billed our insurance company and the claim was denied for being billed past the filing limit.
The collection company that has the bill ($29,000.00) has called both me and my son almost everyday since they turned it into collection demanding that my son pay them in full and take out a loan for payment to them. The establishment will not settle the amount, nor will the collection company. Neither the collection company nor the establishment were willing to set up payment arrangements until the third party payer settled the claim. They want payment in full, even though they are contracted with our insurance company. I asked the collection company to quit calling both my son and me and they continued. Is that legal? I SO need some help with this matter. Any suggestions? Any place that I can find info on any laws that I might need to have if/when we go to court? Please help. My son was 20 years old when he got hit on his bike. He competes nationwide in Xterra events, goes to college for Exercise Science and Aquatics, and also works as a personal trainer, swim coach, and lifeguard. We needed to get his surgery done ASAP; his livelihood depended on the use of his knee. I feel very cheated and coerced. Please help!
Laura T.
Dear Laura,
I wish that I could tell you that it is the hospital’s responsibility to bill your insurance, but unfortunately it’s a luxury. In the fine print, the hospital always mentions that it is a patient’s responsibility to follow up with their insurance and send a bill. Also, there is no time allotment for when a bill is to be turned over to a collection agency. I once collected on an account that a hospital turned over ten days after the date of service.
However, this does not stop you from your legal right to dispute a claim. Since you did contact your insurance company regarding setting up a subrogate claim, dispute the bill with both the collection agency and the medical provider. Make sure to cite all contacts with the insurance company and doctor regarding this incident.
On the other hand, in order to stop being harassed until the third party settles the claim, yes the collection agency must legally stop contacting you. Since you informed them of your right to stop contacting you, they legally have to, but since it was only verbal, they can deny being told. In the dispute letter, tell them that you are invoking your right to a verbal cease communication and that they may only contact you through written letter. In the meantime, start sending in ten or twenty-five dollars a month. This will let them know that you are serious about getting the bill paid, but you will have to do it on your terms.
Do YOU have a question for Melissa? Email her at melissa@dovcocs.com.
Melissa Douros
Dovco Collection Solutions, Inc.
As the owner of Dovco Collection Solutions, Inc., Melissa Douros uses her eight years of being a collections specialists to offer advice and answer questions pertaining to debt collection. With running her own successful collection agency, she seeks to keep debt collectors accountable for their actions and in line with the law.
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