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Billing or Collector?

Date: Sun, 10/14/2007 - 08:24

Submitted by goldenbast
on Sun, 10/14/2007 - 08:24

Posts: 2884 Credits: [Donate]

Total Replies: 8


Well when it rains it pours. My hubby had to go to the ER one night, which we have a $100.00 co-pay. We went, the rep asked us if we had the $100.00 and we asked to be billed. No problem. At the END of the treatment, they came up to us and told us that they are not a part of our plan, that next time we should go to this other hospital.

So we get a bill for almost $250 bucks. I call and find out that since they are not a part of our ‘plan’ that our insurance only paid them a partial payment. So we owe the rest. I’m pissed. Why did they not tell us this when they first asked for the co payment? Why did they wait to the end of services??? I basically got, ‘oh well too bad you owe it.’

I called our insurance and basically got the same thing, since they aren’t part of the plan, they only pay a certain amount. Well this is just great. I get a few bills from the hospital, finally I send them a letter explaining the situation and that no one told us before services were rendered, that they told us –after-. I believe we are only responsible for the $100.00 co pay.

Just a few days later we get what looks like a bill from a QUE Financial, they say they have been contracted to manage our account. I looked them up on the BBB and they are listed as a billing service, but they have a DBA as Accounts Receivable Management Systems which is a known CA. My question is since the hospital already sent us billing, are these guys a CA? They did not give us a mini Miranda and made their letter look like a billing statement.

What do you guys think?


I'm not sure about them, but I have dealt with hospitals for over 24 years, when my son was in and out of hospitals.

The hospitals here have a thing, that if the bill isn't paid in say, 30-60 days, they have a billing/collection/attorneys office handle them.

I have never had problems with making arrangements with them. I paid on one bill for 4 years when our insurance company went into bankruptcy.

Just make sure that you aren't getting double billed on this. If they are a collection agency, they have to put the mini miranda on correspondence, if I am not mistaken.

One time we took our son to the ER that was closest to our home, knowing it wasn't in the network, but he was really ill-having an asthma attack. I explained this to our insurance, and they ended up paying because it was a medical emergency and the closest hospital..Good Luck to you..KAren


lrhall41

Submitted by Bossy4455 on Sun, 10/14/2007 - 08:38

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I know about CAs having to put the mini-miranda, but Im just scratching my head over the distinction that they are a 'billing' service.....but the hospital already had a billing service and threatened to goto collections, then I get this last letter...makes me think they are in fact a CA, but they could try to argue that they are billing. Hmph.


lrhall41

Submitted by goldenbast on Sun, 10/14/2007 - 09:10

( Posts: 2884 | Credits: )


Usually insurance will wave the out of network if it is an emergency that requires the faster access to medical services. I would got to the hospital and talk to the billing manager. Explain the situation to her. Many times the manager can get things doen. If that does not work got to administration. Talk to either the CFO or CEO. They do nopt want bad publicity out about their hosputal not working with people. Usually one of them will fix the problem, if the billing manager won't.


lrhall41

Submitted by pybasj on Sun, 10/14/2007 - 10:12

( Posts: 818 | Credits: )


Thanks! That is a good idea. I will wait a bit and see if I get any response from the letter I sent. The new billing letter I got just a few days after I sent the letter, so it was obviously sent before I sent my letter. If I get nowhere with the letter then I will try your suggestion. Thanks again!


lrhall41

Submitted by goldenbast on Sun, 10/14/2007 - 10:33

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