Infusion center billing

I could use some help. I have been receiving infusions for 3 years now and recently the first infusion center I was with before going to home infusion fouled up their billing and after 2 years has determined I ow them between 0 and 180,000.00 dollars. I have been to their office to speak with the office manage or billing department and no one can produce statements or billing to explain how the came about their numbers 2 years latter. They are threatening collections and yet each week I received acknowledgement from their billing department that everything had been covered by the insurance. Now I am dealing with unnecessary stress and can’t get a straight answer from them.

Frustrated

Hi Robert,

You have a legal right to you medical records and your billing records. You can read more about that here. At this point, consider drafting a brief log of the events so far, names and dates if you have them, and gather all your correspondence and stick it in a file. As this continues, add every phone call to your log and every letter to your file.

You may want to consider following-up with the infusion center in writing: request your records with a copy of the above information, which states you have a right to access these records, and a letter about your concerns, which you can send by certified return receipt mail or by dropping off the documents in person (but consider asking for someone to sign for receipt anyway). You may want to state that you dispute the charges or that you do not understand the charges or both, whatever is most accurate. Do list the efforts you have made to resolve the problem and the failure on their end to resolve the problem. Be clear and polite, not hostile, which may be easier said than done. If they continue to refuse to provide your records, you may need to engage an attorney, but it should not come to this- they KNOW you have a right to your records. However, if you do need an attorney, if will be cheaper since you will have lots of information prepared and it will cost very little compared to 180K in collections.

When you review the records, you want to know when your claims were filed with your insurance company, if or when the insurance company rejected the claims, the billing code used to file the claim and the code used to reject the claim, if any claim was in fact rejected. The codes may be important, for example, if someone used the wrong diagnostic code (maybe they billed for GBS or MMN, not CIDP) and the insurance company rejected your claim because you do not have the disease for which they billed. If the claim was rejected by the insurance company, the code should tell you why, such as deductible not met or out of network provider. Maybe you will see an obvious mistake that lead to all of this confusion.

You should also be able to obtain this information from your insurance company. You want to review your EOBs or Explanation of Benefits. You may have received these in mail or they may be available online. If you do not have the EOBs, call the insurance company. It sounds like it you can honestly state that someone at the infusion center says that the insurance company did not pay your claims or all of your claims, so you need the evidence or more information.

If you are sent to collections, please read this about your rights in CA. Under the section "If the Bill was Paid", you will find instructions for submitting the evidence you gathered above to prove that you do not owe this debt. The other sections will help deal with the general collections process if this is new for you. That link will also help you file a complaint with the state, if needed.

Please PM me if you have additional questions.

Joy

How dare them!

Well that sucks. If it keeps going this way your going to have to lawyer up.