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Medical debt I don't ower Michigan

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  • Medical debt I don't ower Michigan

    (Right, apologies for typo in title that I didn't notice until I hit "post.")

    I've been fighting for several months with the hospital my doctor's office sent lab tests off to. They received an Explanation of Benefits from my insurance company, and later a revised EOB due to error that states I owe less. They continue to bill me the original amount. (It's not THAT much more, but I could use the money, and it's the principle of the thing.)

    They keep insisting they don't receive the revised EOB, even though my insurance company told me they sent it multiple times... AND they expect me to do the legwork on this-- sending them a new EOB, etc. I'm not sure why I need to be doing the work when they're the ones who want to get paid, frankly; I'm really tired of jumping through hoops for them.

    I've called my insurance company twice to request a new EOB for them, as they insist they won't call the insurance themselves. Can't tell you how many times I've gone back and forth between the two, verifying addresses, and such. (They tell me the address the insurance had is for their corporate office and they may never receive the EOB-- funny that they received the first one showing the incorrect amount with no hassle, and not the several they've been sent since.)

    I'm ready to wash my hands of this-- if I call their billing department and pay only the amount I actually owe and then forget about it, can they take legal action against me for the rest if I don't actually owe it (even though they refuse to acknowledge that)? Or am I on the hook until they're finally willing to acknowledge the revised EOB? (I know if I pay the full amount and then try to resolve it, I will never get a refund.) I would like to be able to just pay the correct amount and say "I'm done as I have no further responsibility to you" but I'm not sure if it's that easy. Seems to me their beef is with the insurance company and not me, but it'll be so much easier to take it out on the one without the corporate lawyers. (My doctor's office is currently dropping their affiliation with this hospital, and my doctor tells me I'm not the only one who's complained of billing problems with them.)

    Thanks.

  • #2
    I have no suggestions for you since you've made it clear that you are not interested in taking any action yourself, but in forcing everyone else to take it. The obvious answer would be for you to provide a copy of the corrected EOB, but since that's "not your job" I don't know what else to tell you.

    Except that yes, if you do not pay what the hospital believes you owe, they can take legal action. You might ultimately win, but it would really be much simpler in the long run just to give them the EOB yourself whether it's your responsibility or not.
    The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

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    • #3
      Most doctors' offices have patients sign paperwork agreeing that if insurance companies don't pay, the patient is responsible. So you may be cutting off your nose to spite your face. I agree with cbg that you need to take whatever steps needed to correct the wrong amounts.

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      • #4
        Originally posted by cbg View Post
        I have no suggestions for you since you've made it clear that you are not interested in taking any action yourself, but in forcing everyone else to take it. The obvious answer would be for you to provide a copy of the corrected EOB, but since that's "not your job" I don't know what else to tell you.

        Except that yes, if you do not pay what the hospital believes you owe, they can take legal action. You might ultimately win, but it would really be much simpler in the long run just to give them the EOB yourself whether it's your responsibility or not.
        I've worked in medical billing a number of years, and agree with the above posts. Just include a copy of the EOB with your payment, and ask that they send you a statement stating your account is paid in full.

        Typically, medical offices will send accounts to collection agencies that specialize in medical billing. Upon receipt of your EOB, they would adjust your account appropriately. They would only escalate to legal action after exhausting all other collection efforts, and it's a waste of their time to involve an attorney when the EOB clearly shows what your responsibility is - the lawyers are for willful non-payment.

        I understand this is frustrating for you, we all do. But you'll only get more frustrated getting bill after bill and eventually collection notices! Send in EOB and nip it in the bud...and then enjoy the rest of your day!
        Last edited by henbob6; 09-18-2013, 05:37 AM.

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