Rights You Likely Didn't Know You Had
Medical collections are an issue for both the insured and uninsured. In fact, 1 out of 5 insured Americans encounter problems with medical bills. Some causes are claim denials, poor billing practices, deductibles, etc.
Most troubling is that many people don’t know or understand their rights. Below I outline a few laws and practical advice to help take control and combat medical collections insured or not.
National Consumer Assistance Plan
Medical collections cannot be reported until they are 180 days past due. After 180 days, if it’s paid by by your insurance, it must be deleted. The medical collector has 45 days to do so.
Take Action: Review your credit reports for medical collections. Check the date reported and compare it to the date you received medical services. If the debt was reported within 180 days of the date of service, dispute it with the 180 day letter in our Facebook group.
If paid, send a dispute letter to the three major reporting agencies. Include a copy of your Explanation of Benefits (EOB) if you have it.
ACA - Medical Billing for Non-profits
According to the Affordable Care Act, non-profits have specific requirements to ensure patients are protected from debt collection. Certain activities are prohibited before engaging in extraordinary collection actions (ECAs). This includes negative credit reporting.
Key Points:
- For starters, each non-profit hospital must develop a written financial assistance plan.
- A reasonable effort to determine if you’re eligible must be made.
- You must be notified about their financial assistance plan before ECAs.
- The notification must identity the action they plan to take and the date.
- The hospital must provide oral notification at least 30 days before an ECA.
- They are responsible for ensuring that debt collectors are subject to the same requirements.
- In addition, all collection activity must stop if you apply for assistance within 240 days.
Take Action: Ask yourself if you were ever notified about their Financial Assistance Plan.
Did you receive a call 30 days before the ECA? If not, send a letter to the hospital collections dept and the medical collector outlining the violation.
Be sure to removal from your credit report. Request the application for financial assistance.
Medical Debt Relief Act 2018 – Pending
This legislation has been reintroduced and is not yet enacted.
The request is to amend the Fair Credit Reporting Act (FCRA). The goal is to remove paid-off or settled medical debts from your credit report within 45 days. It wouldn’t matter if YOU or your health insurer settled or paid.
Another change is to amend the Fair Debt Collections Practices Act. This amendment would require debt collectors to provide 180 days for verification. The clock would start from the date the statement was sent. The notification will also require them to add the specific date the debt will be added to your credit report.
Take Action: Join our Facebook group so you’re one of the first to know if and when the legislation is enacted.
Practical Advice:
Below are some additional actions you can take to remove or prevent medical collections from being added to your credit reports.
Learn the Timely Filing Requirements
Call your health insurer to find out if the debt was ever billed. Also ask about your rights as it pertains to timely filing. Almost all providers have a timely filing requirement/clause in their contract.
There’s a possibility that you may not be responsible for all or a portion of the bill. Some states also have mandates to enforce timely filing requirements. Be sure to do your research.
Follow Up After a Medical Visit
Some provider and hospital billing departments have poor billing practices. Get in the habit of setting a reminder to follow up on medical bills. I normally set a reminder for 30-45 days to contact the provider’s billing department. I need to know if the claim was submitted to my health insurer.
Review Medical Bills and EOBs
Read your medical bills and EOBs closely. Review the services billed and look out for overpayments during your visit. Also look out for erroneous charges for services you didn’t receive.
Keep in mind that most providers you visit have a contract with your health insurer. Your financial responsibility will be displayed on your EOB. If it’s incorrect, contact your provider and/or health insurer.
References:
- Billing and Collections for non-profits: https://www.irs.gov/charities-non-profits/billing-and-collections-section-501r6
- Medical Debt Relief Act: https://www.acainternational.org/news/medical-debt-relief-act-reintroduced-in-senate
Sarita Owens, MBA
Sarita is a Certified Credit and Financial Health Counselor and a Board Certified Credit Consultant.