Collection Agency trying to collect on fraudulent claim

[ukgal]

My medical insurance refused to pay a claim submitted by a dr, as he tried to submit a duplicate claim for a single service on same day. My Explaination of Benefits from the Medical Insurance states that this claim is being denied as it is a duplicate claim that was submitted for a service that a claim was already put forward to..so basically the dr has comitted fraud, and now my pristine credit report is being ravaged by this collection agency....what are my options here . I told them I would file suit, and they said they would defend their case vigorously..I said fine..it will cost me more to file than the disputed debt amount which is $45 ?

 

[applebee]

Play the game like they are

I am not sure what state you live in, but in california the fee to sue them is around $16 for small claims court. What i would do, is to write the collection agency a letter disputing the claim and ask them to provide you with proof of the bill within 15 days. I would also call the doctors office and dispute the claim with them. forget the collections agency and go for the doctor. as we all know that doctors time is very expensive, let the doctors office know that you will file a claim in small claims court against the doctor himself in the amount of $5,000 dollars (in california) in or about 15 days from now. with the doctor himself named as defendant. if no response.... go ahead and file... it is actually too easy to do, and under the part where you state your claim write something to the effect "I will dismiss this claim if the billing is corrected and removed from collection agency and all negative items removed from my credit reprts in regards to this matter". this will get you immediate action from the doctor...... as he is not going to show up for court for $45, and if he doesnt show..... you win $5,000. so when they call you to let you know they have taken care of everything and you can now dismiss your claim....PLEASE!!! let them know you expect the $16 for the filing cost. you will be amazed of how well and how fast that works!

 

[Michael Wechsler]

My medical insurance refused to pay a claim submitted by a dr, as he tried to submit a duplicate claim for a single service on same day. My Explaination of Benefits from the Medical Insurance states that this claim is being denied as it is a duplicate claim that was submitted for a service that a claim was already put forward to..so basically the dr has comitted fraud, and now my pristine credit report is being ravaged by this collection agency....what are my options here . I told them I would file suit, and they said they would defend their case vigorously..I said fine..it will cost me more to file than the disputed debt amount which is $45 ?

I am not sure what state you live in, but in california the fee to sue them is around $16 for small claims court. What i would do, is to write the collection agency a letter disputing the claim and ask them to provide you with proof of the bill within 15 days. I would also call the doctors office and dispute the claim with them. forget the collections agency and go for the doctor. as we all know that doctors time is very expensive, let the doctors office know that you will file a claim in small claims court against the doctor himself in the amount of $5,000 dollars (in california) in or about 15 days from now. with the doctor himself named as defendant. if no response.... go ahead and file... it is actually too easy to do, and under the part where you state your claim write something to the effect "I will dismiss this claim if the billing is corrected and removed from collection agency and all negative items removed from my credit reprts in regards to this matter". this will get you immediate action from the doctor...... as he is not going to show up for court for $45, and if he doesnt show..... you win $5,000. so when they call you to let you know they have taken care of everything and you can now dismiss your claim....PLEASE!!! let them know you expect the $16 for the filing cost. you will be amazed of how well and how fast that works!

Great post applebee. You might want to send the letter certified return receipt to the collections company with a copy of the proof from your insurance company that it is a fraudulent claim. You should also send a copy of the correspondence to the big 3 credit reporting agencies and demand that this error be removed from your account immediately. You should also make reference in the letter to the language they used about "defending the case vigorously" and inform them that you will seek all damages avaiable to you under law and the The Fair Debt Collection Practices Act (FDCPA.) You should also demand this matter be resolved within 30 days or you will proceed. They may take you a lot more seriously. Whether you want to file in small claims court and ask for additional damages (and let the court decide) is up to you. If it was me I would definitely file a compaint for fraud with the state attorney general, both against the doc (only if you know that this was an intentional attempt to double dip, not a guess) and especially against the collections company.

Good luck to you and I hope it all works out for you!