Collections Law/Medical Bills

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Question
QUESTION: Hello,

I recently incurred some medical bills.

A family member recently had two separate psychiatric hospitalizations.  She is bipolar.

I accrued somewhere around 100K + in bills.  Fortunately insurance covers the bulk of it (though my insurance doesn't pay until I've made a payment). Out of pocket I am looking at somewhere around 8-10K from this whole period .

I could pay it off in a lump sum, but obviously do not wish to pay more than I have to out of pocket.  

What is more, I am VERY dissatisfied with the treatment/service, particularly that associated with the first, longer stay.

The patient was admitted involuntarily during a manic episode and refused treatment.  She was in the hospital for 20+ days, and received no medication, and not a whole lot of attention, as far as I can tell.  The DR was unprofessional, discourteous, and wasted a whole lot of my time

Within the first 5 days, I was asked if I would be willing to testify in court to have the patient medicated against her will.  I said yes.  But instead of getting into court on the next available day a couple days later(court is weekly on Thursdays), we did not get in until 1 week after the next court date -- that represent about 11 days (7 extra and totally unnecessary from my perspective) where she was housed, untreated, racking up $2800 a day in bills.

After we finally got into court on about day 16, The judge ruled that the patient may be medicated against her will.  I am unclear the exact nature of the ruling.  The dr. later suggested that he was not given authority to inject  ...  in any event, the hospital held her for 6 more days after the ruling without administering any medication.


So I count at least 13 days of 20+ that the hospital was racking up bills and not taking proper action (including not enforcing a court ruling to medicate)  

I do not wish to pay for this.  I wonder what are my options:  

1) Should I file an objection with the hospital?

2) Should I raise a flag with my insurance company? (does doing so represent any risk to me that they will withdraw their coverage of the incident and leave me holding the bag)

3) is this a small claims court case?

4) is there some advocacy group, or standard form or...

Is there a professional I could get to look at these bill (at a fee that makes sense), such that (s)he could probably save me 2,3,5 K, (and charge less than that?

I want this off my books and resolved.  but like I said -- these bills (plus a couple 911/emergency bills) represent a close to $10,000, and that would hurt.

Appreciate any feedback/guidance!!!

Thank you,
David Dillon

ANSWER: Involuntarily comment is a touchy situation to say the least.  There had to be a doctor or a court order involved?? If you are not satisfied with the services, you should file a complaint with the American Medical Association, Consumer Affairs and The Secretary of State in your home state. I can get the information you need, but i need to know what State you live in. There are also companies that you can hire to audit the bill. There again, I would need to know where you live (city/state) to get the websites for you.

As to your question in reference to Small Claims Court, this is too much money for them.  Filing a complaint with the hospital would not do much good since they are supposed to be following a Doctor's orders.  This gets very tricky and you would need professional advice from an attorney.

I hope this helps and wish you the best with this.

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

QUESTION: I live in NY State, Kings County (Brooklyn.  It would be very helpful and very much appreciated if you could point me towards the correct NY State contacts to file complaints.  

Is there a downside/drawback too filing?  

And I have basically avoiding talking to my insurance company ... would there be any possible benefit to alerting them to my dissatisfaction?  Would there be any potential risk (that they may withdraw the claim approval or anything else?

Thank you Again

ANSWER: Glad to help.  There is no downside to filing complaints as long as you are perfectly honest to the facts to the best of your knowledge. Before I filed these complaints, I would let the people you are filing against know of your intentions.  A lot of times letting them know will do the trick.  I hope this information helps and if I can be of further assistance please let me know.

AMA:

http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-

New York City Consumer Affairs:

http://www.nyc.gov/html/dca/html/resources/complaint.shtml

New York Attorney General:

http://www.ag.ny.gov/complaint-forms

Better Business Bureau

http://www.bbb.org/new-york-city/accredited-business-guide/find/-/brooklyn-ny/




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

QUESTION: Thank you, Ray,

I really appreciate your help.

If the suggestion of my filing formal complaints may make them revisit/negotiate the bill with me, that is a course I would like to take.

2 Qs:

1) who would you suggest I make that intent known to and how to most likely get them to expunge some of the owed money?

2) Would it be in my interest to raise a flag with my insurance company, which is on the hook for about 80K?  Would they fight the hospital on the bill to my benefit, potentially?  Or would it potentially leave me exposed to owing more, if they revisit the claim, deny and leave me responsible (that is my fear, not sure if it is a legitimate one)

Thank you.
David Dillon

Answer
You may want to get legal advice on whether or not to get the insurance company involved. $80,000 is a lot of money!l

You need to send your intentions to report this issue to the Administrator and the Chief of Staff of the hospital.  Look the hospital up n the internet and see if you can find the name of the Chief Legal Counsel.  Include him/her in the notification process.  Send all information by certified mail and state all of the facts to the "best of your knowledge" and in plain old everyday language, leaving out all emotions.

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Ray A Miller

Expertise

I am qualified to answer questions on the following subjects: FDCPA, FCRA and HIPAA as well as medical collections, general collections and collection agency related issues. I trained these subjects at a nationwide collection agency and customer service call center and audited around 150 representatives for compliance to the laws. I have been in the Collections Industry for over 30 years. I feel that everyone deserves to be treated fairly and with compassion and that is the way I trained collectors. Even though I worked for a Collection Agency, I get great satisfaction in helping those who have been mistreated or in need of help with these confusing issues.

Experience

I was the Compliance Administrator with a nationwide collection agency and customer service call center-I have trained hundreds of collectors on the above referenced topics. I have been in the medical collections industry for over twenty years and research these topics on a daily basis.

Organizations
ACA International

Education/Credentials
Some college ACA Certified Collection Specialist

Past/Present Clients
I am retired due to medical conditions and spend a good deal of time keeping current on collection issues.

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