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Q: Hospital won't take responsibility!
asked by: bradshannon on October 1st, 2009
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My wife had a baby over 2 years ago, before we were married, and we just got a notice in the mail that we had been sent to collections. We received no mail or phone calls about the bill until now.

The entire birth was covered under my wife's medicaid insurance. However, the hospital filed the claim under my step-son who was being born at the time. Since he had no insurance, they were unable to get paid for it. My wife has called Medicaid, the hospital, AND the collections agency trying to get it resolved and all of them are giving her the run-around.

The hospital says it's too old to fix and we have to pay the bill. The collections agency said to file a dispute, which we did, and it came back saying that they couldn't fix it. Now, Medicaid is saying that the hospital has to fix it.

This is obviously the hospital's fault and they refuse to take responsibility for it! What do we do?!?
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zigemyster
replied on October 6th, 2009
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First I would write a letter with facts to insurance coverage at time of service, how long she was in the hospital as well as her son.

She can also state that she never received any statements / correspondence, etc regarding their stay.

Ask for the hospital for an audit of the account, dates of when they sent statements and to what address...was it addressed to her or to the son.

Send a copy of this letter to the Hospital Administrator, Collection Agency and to Medicaid. Send certified. You will also need to include your Medicaid number that can identify you and / or your son for date of service in question.

This will be your official dispute. While this is being reviewed ... collection effects should be placed on hold.

She is told that it is "too late"...that is NOT true. They do not want to go back and try to figure out what went wrong. It could have been billed under the wrong ID or something else. It happens.

Approximately 10 days after you submit your dispute...give each one of them a call to check the status of this. Keep documentation as to whom you spoke with, date, time, etc...

Those three agencies need to communicate with each other to get it resolved and notify you all of the findings.

If Medicaid tells her that the hospital billed it incorrectly...whether it was under the wrong ID, name, etc... she may want to mention to Medicaid to contact the hospital directly as the hospital refuses to fix.

However a certified letter detailing all of this is the route.

Collection agency said they couldn't fix? They can't...generally if a claim was billed incorrectly...it goes back to the provider to fix and since the hospital said it is too old...yep, she is getting the runaround.


Zig
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W0LF
replied on October 6th, 2009
Extremely eHealthy
Check with your state attourney general about your rights against a collection agency. Most states have pretty rigorous requirements as to the need to notify the collectee of the debt prior to turning it over to a collections agent. Collection agencies also have pretty strict codes of conduct they have to follow and violation of state code can get a collection attempt thrown out of court.
Also don't be intimidated by the collection agent. If they start talking about legal action just ask them for the name of their law office so you can advise your attourney.
You have rights, specifically because stuff like this happens all of the time.
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