

Ask HN: What to do about my erronious medical bill? - jisaacstone

A year ago my wife an I went for our annual physical. It should have been free under our insurance. Mine was, but she got a bill for $214. I have called, written, emailed repeatedly both my insurance and the clinic. This is the story each tells me.<p>Insurance: "We only charge because of how it was billed. You'll have to get the clinic to change the billing codes"<p>Clinic: We don't guarantee anything will be covered. Call your insurgence.<p>I've looked at the codes. They are the same. With this information I was finally able to get someone on the phone with the insurance company who knew what he was talking about. It went something like this:<p>"Hi this is Ted how can I help you?"<p>"The same codes were used for my wife and me, how come she is billed an I am not?"<p>"Hold on let me get my boss"<p>"Hi this is Tom how can I help you?"<p>"The same codes were used for my wife and for me. Why is she getting billed and I am not?"<p>"hold on let me get my boss"<p>"Hi this is Mike how can I help you"<p>"The same codes were used for my wife and for me. Why is she getting billed and I am not?"<p>"Let me look"<p>"Oh, she was billed as diagnostic, and you were billed as preventative. You'll have to get the clinic to change that"<p>So I call the clinic and they say of course, they will resubmit right away<p>Now, A month later, I get a note saying the bill is being sent to collections.<p>So here is the deal: Insurance refuses to do anything. The clinic always says they will take care of it but never does. From what I can tell the fault is with the clinic.<p>How can I make them do something. Is there some sort of formal notice I can send? Should I get a lawyer? What kind of lawyer?<p>Should I ask this question on some other forum? or Reddit maybe? Help my out gentlemen.
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patio11
For $214 there is no rational upside in sending a lawyer.

You seem to be doing a lot of phone calls. _You should stop speaking on the
phone about this._ Send a letter, on dead tree, "return receipt requested" to
Accounts Receivable at the clinic. Say that you talked to A, B, and C on X, Y,
and Z dates, that their staff has accepted that this is a data problem on
their end, and that they should promptly re-code this and re-submit to
insurance. Tell them that, if they fail to do this and instead send this to
collections in error, you will explore your remedies under the Fair Credit
Reporting Act and other avenues which are available in your state.

~~~
jisaacstone
Yes, I felt this was correct but I could not find anything to cite. Vague
threats did not seem the correct way to go.

I just read about the Fair Credit Reporting Act and that seems to be exactly
what I was looking for.

Thanks a bunch.

~~~
patio11
Truth be known it is a bit of a stretch, but it will achieve the desired
result (escalation internally).

