I need your input. Today we got a letter from a collection agency for a 2019 medical bill. We don’t think we owe this bill, as the dental office failed to correctly file with our insurance, according to a letter we have from insurance. I suppose they would see it differently.
We’ve never had to deal with a collection agency. The date listed is one month within my state’s 4-year statute of limitations (after which the collection agency cannot sue for payment, though after which, they can still try to collect and can still submit this to a credit reporting agency). It seems from our research our first step is to, within 30 days, “dispute’” the debt by writing and asking for additional information. What we’re wondering: Should we just pay it to avoid future problems? What would be the future problems? Should we contact the medical office and negotiate directly with them? Perhaps offering to pay a portion in exchange for clearing us of the alleged debt? Or should we only deal with the collection agency? What would happen if we just ignore the letter? The collection agency does seem legitimate, with a good BBB rating.
Did the office have all of your up to date policy information and know billing was expected of them?
If so, I’d call the insurance company and ask how to proceed.
If not, some of this will fall on your shoulders. It is ultimately the patient’s responsibility to give the proper information.
If there’s anyway that you were part of the problem, just call the office, explain the mistake/miscommunication and negotiate an amount to make it go away.
I had a similar issue once, about a year after date of service. I called the dentist’s billing clerk who basically said they hadn’t properly submitted it. She submitted it and the problem was resolved.
I’d contact the dental office and ask them to explain what happened. Then I’d call the insurance company.
I had such an issue years ago. My insurance was ending and I had a procedure in process. I told the dentist I HAD to have the work completed by July 2 and he said it wouldn’t be a problem to have it billed. BIG problem as the billing was screwed up. I received a letter in August saying insurance had denied. I explained it all . This went on for months, maybe even a year. Letters back and forth. The dental office kept putting the wrong dates on the claim and the insurance kept saying it was past the date of coverage. The insurance company said have them fax it in. Dental office said their fax machine was broken. This crap went on and on. Finally, I said fine, everyone send me all the documents about the claim and the denials as I’m going to file a complaint with the state insurance commissioner. Miracle! claim was paid (and I never got the info from either the dentist or the insurer). Well, except for about $60 the dentist said wasn’t covered. BS, I paid for whatever wasn’t covered at the time of service (I think it was some special material for the crown). I never paid it and finally they stopped sending letters.
He really was one of the best dentists I’ve ever had, but his front office was terrible. The insurance was also top of the line and had paid everything prior to that if billed correctly.
Was this dentist part of your dental insurance network, such as a PPO or managed dental care program? If it was, then the provider typically has the primary responsibility to submit the proper claim to the insurer, and you may be able to push back on the dentists office: they didn’t get paid bcos they did not follow the contract that they had with the insurance company for being a preferred provider.
Back when I was involved in insurance programs, a claimant or dentist had 2 years (24 months) after the date of service to file a claim. Otherwise, the books were closed and a later claim would not be reimbursed. Of course, every insurance contract would define any time frames.
Same happened to us…except we had an EOB that said the bill had been paid (for a Life Star trip) two years prior to the letter. I called the insurance company and clearly stated that we had coverage with them at the time, and the bill had been paid…and we had coverage for this service. (It’s not like my husband had a choice about Lifestar…or not).
The ambulance service was zero help.
But the insurance company did send them a letter saying this claim had been paid.
Sometimes their record keeping gets botched up.
I think this is an issue you absolutely need to address with the insurance company. Perhaps they will reach out to the provider for a new submission. Worth trying.
Is this the first time you’ve been made aware of the situation? It seems bold for them to wait so long. But… I can see why you might be tempted to pay if it is a tolerably low amount.
This is from 2019. I was surprised to get this bill back in the day as I had paid in full, I thought. But you know how that goes … they say that number was just an estimate and more charges might be incurred. When we got the letter from our insurance saying that they already had paid this claim and that the dentist, basically, needs to fix it on their end, I forgot about it, figuring it would get settled eventually.
It’s less than $1k but not much less!
I think that we should call the dental office, ask whether this debt collector is working on their behalf or whether they bought this debt. If working on their behalf, I would ask them to address the letter we got back in the day. Or I would offer them some amount to settle it.
I was told by children’s medical center that I had a nearly 2 year overdue bill for the birth of our D, when D was hospitalized with a serious infection at age 20 months. I was very surprised and asked for an itemization because there was no copay when S had been born 4 years prior and the coverage and insurer hadn’t changed.
The medical center said they didn’t have and couldn’t provide any itemization as it was too long ago. I said fine but I can’t pay unless I get an itemization, so medical center said never mind, ignore bill. Never got another bill for D’s birth.
I guess since you no longer have that insurer, I’d call the dental office.
If the collection agent were to report it to the credit bureaus then you would need to explain it every time you apply for a loan. It is not worth it even if you are in the right. I would contact the dental office to get them to re-submit the claim. If your insurance company won’t pay because it has been too long (you can find out if they are obligated to pay) then I would try to settle with your dentist.
Insurance companies are heavily regulated, so they will generally do the right thing.
Where is the discrepancy coming from? Did the dentist submit new charges that they forgot to bill the first time? Or are they saying you owe more than the insurance company’s allowable charge?
We had a doctor’s office bill us over a year later for a regular office visit with labs, etc. It said it went through the insurance and they paid zero and we owed the full amount. I pulled up the EOB. Well we do owe the “full amount” because we have a high deductible, but the allowable charges were but a small fraction of the original cost. So I paid what the EOB said I owed. And I called the office beforehand to tell them what I was doing and also sent a copy of the EOB with my payment. The office kept sending me bills saying I owed the rest. Uh no… I wound up getting my employer’s insurance rep to handle it for me and nobody owed them anything else.
The other was for a wisdom teeth extraction. I paid upfront the estimated charge. Several months later I get another bill for $1000-2000 more. Seems the dental.insurance company kept denying it. I called and they said they wouldn’t process it until they knew the date I started with my health insurance plan. Huh? Why is that relevant. But I gave it to them and it still took forever to get it resolved. What a mess. But that was the insurer’s fault.
So I would figure out where the discrepancy is coming from and who really owes what based on what your plan said at the time assuming everything was filed correctly.
I would never do that. It is the hill I will die on.
You had insurance, you have a letter that said it was paid. If they didn’t bill you in 2019, it’s on them to prove it.
If the debt collector bought charged off debt, they still have to prove you owed the debt. Since you have a letter from the insurance company, I bet they’ll back off soon too.
My father died a few years ago and I was contacting all his creditors including the medical ones. There was a bill from the ambulance company for his last ride to the hospital. I called them and told them how/where to send the bill to be paid. First they said they couldn’t talke to me and I explained that I was their last hope and if they wanted to be paid to do X. I even think they sent another bill and I did it again. Last year I got a bill from a collection company. I called and told them he’d died in 2018. The guy was very nice and took it off their system and I haven’t heard from them again.
I’d call the collection company and tell them you have a letter from the insurance company saying the dentist had been paid.
This is why I NEVER give my SSN to the dentist. They have no need for it other than to collect debts.
Well, the other reason is that dentist offices are prime for information theft and in Florida one of the biggest sources for theft rings to get your name, address, SSN, employer and then they file tax refunds hoping to get a hit.
They can’t just file info with credit reporting agencies unless you owe THEM the debt. If they bought the debt, they still have to make corrections if they report it falsely.
As a doctor’s office on the other side we rarely have to use collections. Call the office directly and get their view of it. Then call your insurance company you had and get back up information. You can also let the collection agency know what your doing. Some offices have contracts with the collections agency and have to pay a fee. If they take you to court you are liable for both the debt and fee.
Also offices make mistakes. Things don’t get applied. We don’t use ss numbers but do get license. You will be surprised how many people don’t pay bills but go to Europe on vacations and show you the pictures. Negotiate this away and move on.
I don’t disagree with pushing back on the dentist’s office and trying to negotiate a settlement. But, this outstanding balance has been assigned to the debt collection company. They get to keep xx% of everything they collect, so they have little interest in settling for a lessor amount. Moreover, unless the dentist’s office made a clerical error and they admit that the reported balance is wrong, their position is likely, sorry, speak to the collection agency. (particularly for a former patient, whose files may be offsite in cold storage)
Definitively investigate to understand if anything is due and payable. Do not miss deadlines with the collection agency or your credit will get dinged. Put everything in writing; send USPS Priority Mail which gives you a receipt and delivery tracking.
@Youdon_tsay I got a stale billing from a collection agency for a doctors group that went out of business. I guess the agency bought stale billing to make some $ - the bill was for $17 which, had I received it when I should have, I would’ve paid. The agency tacked on a $100 late charge. I called, told them the state law about stall medical bills. They dropped the late charge and I paid the $17 - it wasn’t worth fighting over.
I’d contact the collection agency and try to negotiate.
Be careful about “settling” for a lesser amount, especially if it’s the collection agency’s own debt. They could use the unpaid balance as a write-off and still affect your credit. I would ask them to submit a new invoice.
Collection agencies can only tack on fees if the contract (in this case either with the insurance company or the dentist) provides for that or if state law allows it. For example, they could charge a bounced check fee IF state law allows (sometimes a warning is required on the counter at the dentist’s office or on the billing statement), and usually the law sets the amount. Late charges? same thing.
Keep a record of every contact with the debt collector or the dentist. Ask them to send you all the documentation and records of submission to the insurance company. They won’t want to do that so may drop it. And the state department of insurance is your friend. No one wants to answer an investigation. For the debt collector, it’s the consumer office, usually under the Attorney General’s office. They don’t like complaints either.