You visit a medical facility and you’re asked for your insurance information. The health provider makes a copy of your insurance card and bills your insurance company for service.
Even if your insurance information hasn’t changed since your last visit, the provider often likes to double-check that the information in its system is accurate and up-to-date.
Something in that process fell through the cracks when 28-year-old Lemar White, a Piscataway man, visited the emergency room at Robert Wood Johnson University Hospital in May 2011.
“As is customary, they asked for the co-payment and health insurance ID cards, which I provided to them,” said White, who was covered by Aetna.
He was treated and discharged from the New Brunswick hospital the same day.
But that was only the start of his story.
In the late summer of 2011, White received a collections letter from Financial Recoveries about an overdue medical bill from the May 2011 hospital stay. Rather than call the collections company, White called Robert Wood Johnson to make sure it had the correct Aetna insurance information.
Not only was the wrong insurance on file, but they also had an old address for White. That’s why he never received the subsequent bills that were mailed after the wrong insurance denied the claim.
White said the hospital promised to tell Financial Recoveries to stop calling, and it would bill the correct insurance.
But apparently, the collections agency wasn’t notified. On Aug. 16, White, who subscribes to a credit monitoring service, saw that his credit score, which had previously been in the high 700s, had dropped close to 80 points.
It was because of a negative report from Financial Recoveries.
Records show the provider billed Aetna on Sept. 14, 2011, and the bill was paid on Oct. 4.
But apparently, nothing was cleared up on the collections or credit reporting side of things.
A year later, in August 2012, White received another alert on his credit score. It was Financial Recoveries again, the report said, and White’s credit score dropped 57 more points.
“I guess the collections agency updated the credit bureaus to say that my account was still pending payment and once again, my credit score lowered even more,” White said. “To prevent this from occurring in the future, I was forced to pay the collections agency the balance of $378.”
White said he called and wrote to the collections agency, and even asked the hospital to notify Financial Recoveries that the account was satisfied, and in fact, was paid twice: once by White to the collections agency, and once by White’s correct insurance company.
“[Financial Recoveries] called me and said that they would not refund the amount because the account was still a collections account,” White said.
He said he also filed disputes with the credit bureaus, which contacted the debt collector. Financial Recoveries said the account was still in collections, so it remained on the credit report.
In other words, even though White had proof the debt was paid — twice — but no one was taking action on his behalf.
“I provided [the hospital] with the correct health insurance information during my visit,” he said. “I’m very frustrated because this has significantly affected my bargaining power — having a lower credit score. I cannot be held responsible for any negligence in their billing process.”
White said because of the lower credit score, he lost a credit card, and he wasn’t given the lowest possible interest rate on a car loan he took at his credit union.
White wants the hospital to clear things up with the debt collector and clear his name with the credit bureaus.
And one other thing.
White wanted the return of the $378 he paid the debt collector because the insurance company already paid the hospital for that service.
MAKING THINGS RIGHT
Bamboozled reviewed the long paper trail in this case, and we reached out to Robert Wood Johnson and Financial Recoveries. Both organizations promised to investigate.
Within a few days, White received a phone call from the Robert Wood Johnson Medical Group, the faculty practice of the Robert Wood Johnson Medical School.
White learned the hospital is separate from the medical group, and the account with the collections issue was with the medical group, not the hospital.
The rep said the medical group billed White’s old insurance because that’s what information it had on file from a 2010 appendectomy White had at the facility.
“She did not offer any explanation for the breakdown in communication between the hospital and the medical group about why the latter was not given updated information from my visit,” White said. “After they didn’t receive payment — I am not sure how long they wait — they sent it to the collections agency because as she noted, they are not in the business of debt collection.”
White said the rep said her system showed that he called to update his insurance information the year before, but someone either entered the incorrect information or entered it in the wrong field in the system. It also showed when it got the info right, it billed the correct insurance and was paid for the service.
The rep confirmed that the medical group had been paid twice, White said.
“She said that the money was paid to them by the collections agency in August 2012 and they sent me a refund check in the mail to the same old address that they had on file — which they should have realized at that point was the incorrect address,” he said. “And even the collections agency sent the collections notice to me at my new address, so I am not sure why they would send the check to the old address.”
White said the rep asked what White wanted. He said he wanted the refund and he wanted the negative mark removed completely from his credit reports.
White is pleased that the situation will finally be rectified, but he’s frustrated that all his efforts didn’t make it happen.
“I spent months and months, back and forth, trying to resolve this situation and they kept telling me that nothing could be done, and as soon as the newspaper calls them, they hop on it, I guess, to avoid embarrassment,” he said.
A week later, White received another call from the medical group, saying his check was in the mail.
“She also said that she will send me something from the collections company showing that it was removed from my credit report,” White said.
Messages left for reps at Financial Recoveries were not returned, and the medical group would only say “all issues are in the process of being resolved.”
White wants consumers to know that paying a small monthly fee for credit monitoring served him well, and he recommends such services to other consumers.
“Knowing what’s on there and what isn’t supposed to be on there, and getting it off, can save you lots of money at the bargaining table when it’s time to finance something,” he said. “Your financial health is one of the most important things that you have and you shouldn’t allow these big companies to walk over you.”
Well said, and amen.