Expert: Chris Ebert - 8/20/2009

Question
QUESTION: On June 19th, 2008 my wife, Michelle Baker was suffering a migraine head ache.
We went to the JFK emergency room for treatment. This was not our first visit and was in fact our third visit in about a year and a half for the same complaint of a migraine head ache.
Because Michelle is in a debilitated state when we enter the E.R. due to her migraine condition, I ( Roy Baker) generally do all the admitting paper work for Michelle.
The first thing I advised the attendant is that we are a “Cash pay” on this visit and not to engage or involve our insurance what so ever.
I must step back to our first admitting  to JFK to explain further. On our first admitting to JFK for Michelle’s migraine condition, we were again a “Cash pay” client of JFK. The cost for this visit was some $300.00 to JFK which was paid at the time of service  with a follow up bill for some $200.00 for the doctor that came a few weeks later. This was also paid when we received the bill.
On our second admitting to JFK for Michelle’s migraine condition we thought to run the billing through our insurance company.JFK billed our insurance company some $1200.00 for the exact same procedure as was performed on Michelle’s  first admitting to JFK. Our insurance paid some $400.00 towards the balance and we we’re left paying the remaining $800.00. We did indeed pay the full amount due.
This is the reason we we’re so insistent on being a “Cash pay” client for Michelle’s third and last admitting to JFK hospital.
After treatment and at the time to check out, the attendant  advised Me (Roy Baker) that the amount due was $1200.00. I reminded  the attendant that we were a “Cash pay” client and the bill should be some $300.00 and this was not our first time to seek treatment for Michelle’s migraine condition. The attendant advised me that because we had insurance it was mandatory that they try to run it through our insurance first. I in return advised her that that was untrue and not in any way involve my insurance company in this matter. I also advised her of our experience with our first two admittings to JFK and that we knew  very well what the price for treatment should be. The attendant now obviously frustrated with me began pressing buttons on her computer and now came back and advised me that the bill was now only some $800.00 dollars.
I again advised her that we were a “Cash pay” client and that this bill should be some $300.00 dollars. The attendant, now extremely upset with me, grab Michelle’s file and stormed out of the room and in fact left the building and proceeded to the billing department located in the adjoining building .
After about 15 minutes she returned and now advised me the bill was only $340.00 which we paid immediately with a credit card.
We received the expected bill from the doctor some weeks later and it too was paid immediately .
We thought we were finished with this last admission to JFK until we received a correspondence from JFK advising us our insurance company had refused to pay any amount towards the bill and a remaining balance was still owed on Michelle’s visit.
Michelle made many phone calls to JFK regarding the matter and JFK admitted to a mistaken billing in her case and that the problem would be resolved by JFK hospital.
We again thought the matter was closed until we received the collection notice from Central Financial Services  (CFS) which we promptly replied to and advised CFS that we had no intention of paying any more towards this alleged dept and to waste no time filling the needed paper work in small claims court to have this matter resolved .
Have I done the correct thing and where do we go from here ?
Thanks for any help,
Brian Baker

ANSWER: Brian,

You have done what you can do so far. My only suggestion is to send a certified letter to the billing department of JFK to attempt to get them to fix this. You can send a similar letter to the hospital's general counsel.

Other than that, unless you are prepared to file a small claims lawsuit against the hospital and collector, you have done what you could.

Chris

---------- FOLLOW-UP ----------

QUESTION: Hi Chris and thank you so much for the quick reply.
The collection company is already threatening a law suit in small claims which we promptly requested that they waste no time in filing the paperwork needed to bring this case to small claims.
Is there anything I can do about the hospital filing a claim with my insurance company even though we told them not to and in no way to involve our insurance company in this matter ? They did it anyway.
The collection company is claiming that we paid only a "deposit" and the remaining amount is now due.
I have concluded that the hospital only gave us a price to get us out the door and tried to file against our insurance company, against our requests to be a "cash pay" client.
We had/have the means to pay any reasonable amount presented and were lead to believe the debt was paid in full when we left.Again, it appears the hospital simply gave me a  number I wanted to hear to get me out the door and are now claiming it was a deposit only.
We claim we had a credit card with sufficient limits to pay any amount so why would we only pay a "Deposit" at the time service was rendered (which was paid with the same card)and not the full amount owed.
we feel very violated at the hospitals attempt at what we call a fraud in attempting to bill our insurance when we were a "cash pay" client.
We have sent certified responses to the collection company correspondences.
Do you think we have a defense in this matter or should we just settle.We're only talking about $225.00 dollars but for us, its the principle that matters.
Thanks again for your help,
Brian Baker  

Answer
Brian,

Sorry for the late reply.

1) I question any collection company that would sue for $225.00. While I have seen judgments for that little here in Texas it is extremely rare. Consider that they have to pay $100+ to file and serve you and about $250-350 to have an attorney show up to collect such a small amount. I find it unlikely.

2) It is against FDCPA for a collection agency to threaten to sue you in attempt to collect a debt. I would file complaints against the agency with: 1) Hospital 2) FTC 3) your states attorney general 4) www.acainternational.org (industry group) Let each of them know that they are using illegal collection tactics.

3) Finally, I would pay the hospital this small amount and they can refund it at a later date. This stops the collection and buys you time to find a person that will listen to you at the hospital.