Author Topic: Anyone let a medical bill go to collections?  (Read 16952 times)

Lance Burkhart

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Anyone let a medical bill go to collections?
« on: March 07, 2016, 08:58:57 PM »
Long story short, my newborn wasn't insured until the first of this year because I missed the 30-day enrollment window after he was born.  She took him for routine vaccinations for which we received a bill of nearly $1300.  Looking up the costs of the vax and the codes for service, we were charged 3-4 times what we would've paid if insured.  We have a HDHP and an HSA.

I called the billing department to dispute the charges and they wouldn't give me any discount because - again - I was outside some 30 day window and my wife had told them we were insured (I was enrolling my son the week of the doctor visit, though the insurance didn't kick in until the first of this year). 

As a matter of principle I find the $600 dollars worth of charges to be seen by the doctor and administered 4 shots and an oral vaccine outrageous as the nearly $700 for the vaccines.  I'm weighing the pros and cons of stiffing them, though I may be able to get my insurance company to back-date the coverage if my HR agrees.

Questions:
1.  If the bill goes to collections, will collections try to collect ALL of it or some fraction? How much interest will they ask for if I pay the minute it goes to collections (usually this doesn't happen until being 120 days delinquent).
2.  How bad is the hit to my score (I think I'm in the 700s). 
3.  Should I care if my score is hit? (I do not plan to refinance my mortgage.  I might take out new credit cards at some point for travel miles). 

I've never failed to pay a bill or a debt and, outside my mortgage,  I have no debt.  I've seen absurd charges from this conglomerate healthcare provider one too many times for my taste and they seem out to screw the little guy. 

bradleylsmith

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Re: Anyone let a medical bill go to collections?
« Reply #1 on: March 08, 2016, 12:33:05 AM »
They will try to collect all of it plus interest, and they aren't nice about it. If you're willing to trash your credit you can get it down to as much as 25% of the original bill but it's definitely not worth it. You have to drag it out for years and get lucky (in the sense that they don't sue you for the money) during which time your credit goes low. You won't be able to take advantage of CC offers, get a new CC, a car loan will be high interest, etc. etc. And they don't negotiate with people that have good credit so you have to wait until it gets bad.

If they do sue you they can come take it right out of your paycheck and there is a good chance the amount will be with interest and late fees. You will lose the lawsuit of course - you owe the money.

Most of the time insurance gets a much better deal for the same services - they can enforce that because they are essentially buying in bulk. You aren't, I'd just suck it up.

VAR

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Re: Anyone let a medical bill go to collections?
« Reply #2 on: March 08, 2016, 05:01:13 AM »
I did not have a bill that large but I had a bill go to collections ($200)....even though I paid it and had proof. The original Dr office was super sketchy (we had just moved there, live and learn).

They sent letter after letter trying to collect.
Then it went to collections.
and honestly all collections did was send letter after letter. It actually made me laugh after a while because I was absolutely NOT going to pay it on principle. You could tell how the debt got sold time after time as each new company bought it and sent their series of letters.
It was on my credit report for 7 years and now it's gone.

I did call one of the collection agencies once and told them all this. They did not believe me and asked to be send the canceled check....which I did and they ignored. Nobody ever offered to  lower the bills and they all wanted fees on it.

I attempted to file with the credit reporting places but their process was sooooo draconian at the time I eventually just gave up trying to even submit a rebuttal to the charge.

I wasn't buying a house or anything at the time so I just let it sit. To my knowledge it never affected anything I did.
At the time, all the research I did said - do your absolute best to negotiate with the original Dr.....nobody after that is going to negotiate with you on it. I also read in general - if you have any contact with anybody but the original place they will hound you even harder since they got a response out of you.

BlueHouse

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Re: Anyone let a medical bill go to collections?
« Reply #3 on: March 08, 2016, 05:24:38 AM »
I had a medical emergency about 10 years ago and was still receiving bills months later. The final one was for visiting an ER at night and was less than 100$. I was outraged. It went to collections, at which time I said no way, no how would I pay. I demanded that the collection agency provide some sort of documentation that it was a valid charge, and threatened to go to the state attorney general. Not only did they drop it, they put it in writing that the doctor/hospital was mistaken. I think it was a scam because people just pay small bills to be done, but I don't fit that patter.
The next time something went to collections, I had to provide all the paperwork and proof that it had been paid. So I do appreciate that the first company was pretty helpful in getting it all sorted out.

Dee18

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Re: Anyone let a medical bill go to collections?
« Reply #4 on: March 08, 2016, 06:26:15 AM »
You mention "billing department" so I'm not sure if this was just a pediatrician group practice or so something larger.  If it is a pediatrician practice, I would ask your wife--who has the relationship with the doctor-- to write a brief letter explaining she made a mistake when she said the baby was insured and would the doctor please accept the insurance rate as payment in full.  "Disputing" a bill makes it sound like you think the doctor's office made a mistake. They did not.  The mistake was yours, but often when we candidly admit we made a mistake others will help us fix it.  If they won't accept the lower rate, just pay it.  Then google Dave Ramsey's very funny radio program about "stupid tax" in which he talks about how we have all cost ourselves money with mistakes we have made. I am not usually a fan of DR, but I made a big, stupid money mistake years ago that I felt bad about.  This program got me to finally accept my mistake and move on.  People call in and admit the "stupid tax" they have paid.  The story I recall is about a guy who bought an expensive pet monkey that caused a lot of damage.  Then the guy had to pay someone to take the monkey.  Whenever I make a money mistake I think, "at least I didn't buy a monkey."

tljohnsn

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Re: Anyone let a medical bill go to collections?
« Reply #5 on: March 08, 2016, 06:38:04 AM »
I had a bill go to collections about 2 years ago.  It was for a procedure that the clinic estimated would cost total $2000, but then between us and the insurance company billed a total of $11,000.  After the insurance paid $9,000 of they sent us a bill for the remaining $2,000.

I called about it and they said they must have been some complication, but they could not explain what the complication was.  Following that I sent a certified letter requesting and explanation of the charges, and all they sent was the original bill, without even a cover letter acknowledging the dispute.  I sent another certified letter requesting and explanation of the charges, and that the accept the insurance company's $9,000 as payment in full.

About a year passed with no communication from the clinic, and eventually a collection notice came from a third party.  We sent them copies of all the past communications.  Several months later the amount was listed on my credit report as unpaid but disputed.  Credit score dropped from around 750 to 690, but during that time I was also doing some card churning.

I have not bothered trying to get it discharged from the credit report as I don't plan to get a mortgage within the next 7 years, and it hasn't affected my ability to card churn.

dycker1978

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Re: Anyone let a medical bill go to collections?
« Reply #6 on: March 08, 2016, 07:10:28 AM »
This is pretty complainy pants.  You did not tell them you were insured and as a result you have to pay up.  This is the way it works.  You made the mistake, having it sent to collection and not paying is why they have to charge so much anyways.  Because they need to charge enough to pay their legal bills.

You used the service, you forgot to tell them about the insurance, now you need to pay up.


James

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Re: Anyone let a medical bill go to collections?
« Reply #7 on: March 08, 2016, 07:12:30 AM »
You made the mistake, and then you compounded that mistake by not finding out the implications of that mistake in advance. I sympathize, I've been there and made mistakes costing a hell of a lot more than this, but I don't see any better way than resolving this with the clinic directly.


I would do all your homework to try and get the bill lowered. Talk to the doctor, talk to the billings department in person, just keep talking and asking for managers, ask if they have a "patient representative", ask questions and work yourself up the chain and hope you find someone willing to work with you on the amount. Let them know you made the mistake but are asking them to work with you as a lifelong future customer. Remind them you have options and will change where you get your health care if they can't work with you on this. They are a business and you are a customer, there should be some wiggle room, but you also used their services and owe the money, so in the end just pay up.

Lance Burkhart

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Re: Anyone let a medical bill go to collections?
« Reply #8 on: March 08, 2016, 08:13:55 AM »
You mention "billing department" so I'm not sure if this was just a pediatrician group practice or so something larger.  If it is a pediatrician practice, I would ask your wife--who has the relationship with the doctor-- to write a brief letter explaining she made a mistake when she said the baby was insured and would the doctor please accept the insurance rate as payment in full.  "Disputing" a bill makes it sound like you think the doctor's office made a mistake. They did not.  The mistake was yours, but often when we candidly admit we made a mistake others will help us fix it.  If they won't accept the lower rate, just pay it.  Then google Dave Ramsey's very funny radio program about "stupid tax" in which he talks about how we have all cost ourselves money with mistakes we have made. I am not usually a fan of DR, but I made a big, stupid money mistake years ago that I felt bad about.  This program got me to finally accept my mistake and move on.  People call in and admit the "stupid tax" they have paid.  The story I recall is about a guy who bought an expensive pet monkey that caused a lot of damage.  Then the guy had to pay someone to take the monkey.  Whenever I make a money mistake I think, "at least I didn't buy a monkey."t

That's a good idea. Given how long it's been since the date of service I don't think they'll do that but I can try. I offered them $800 yesterday and they wouldnt budge. I'm actually curious to see what will happen if a bill goes to collections. It seems like the powerful like to hold our credit scores over our heads like some sort of sword of Damocles but I'm reading a wide range of answers from certain credit death to no big deal in regards to the outcome. For that reason, I kind of want to try it. What if the bill had been $10k?

Jack

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Re: Anyone let a medical bill go to collections?
« Reply #9 on: March 08, 2016, 08:29:37 AM »
I had a relatively small ER physician bill I refused to pay as a matter of principle that went to collections. Other than an occasional letter, I haven't been bothered by bill collectors about it. It hasn't aged off my credit report yet, but my credit score was over 700 anyway (medical derogatory marks don't count against you as much as non-medical ones).

James

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Re: Anyone let a medical bill go to collections?
« Reply #10 on: March 08, 2016, 08:50:34 AM »
Think of it this way. You bring your car into the dealership and say "change the tires and add break pads". You walk out and come back the next day, and they charge you $200 per tire and $100 per break pad plus $800 for install. So now you owe $2000 to the dealership. You then tell them "that's outrageous!, the repair shop down the street charges half that for the tires and installs them for free." You also pull out an expired coupon for half price on tire and break work at the dealership and show it to them. Do they have any obligation to charge you a lower price, something you find to be more fair? Sure, they could be nice and match prices with the other shop, or honor the coupon that is expired, but fact is you didn't mention any of those things up front, your coupon is expired, and you went to them for the work instead of another shop. Debating and trying to convince them is great, but at the end of the day just pay the bill.


The dealer paid for the tires and pads, paid for the work of the mechanic who put them on, and paid for the building and all the other expenses associated with the work. Stiffing them of payment is theft. I don't see your experience as some big different thing just because it was health care. You accepted actual goods and services, if you don't pay you are stealing.


Sure, health care is a racket and I'm not sympathetic to the clinic for charging you that much, but that is standard in all industries, you buy in bulk and you get a big discount, and that is what insurance companies do. They negotiate and pay a little as possible. And you could have got your vaccines at Walgreens or some other cheaper place, your job was to negotiate and find the best price. But you didn't, you just went where it was convenient, and now you owe what you owe.

Jack

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Re: Anyone let a medical bill go to collections?
« Reply #11 on: March 08, 2016, 08:57:57 AM »
Sure, health care is a racket and I'm not sympathetic to the clinic for charging you that much, but that is standard in all industries, you buy in bulk and you get a big discount, and that is what insurance companies do. They negotiate and pay a little as possible. And you could have got your vaccines at Walgreens or some other cheaper place, your job was to negotiate and find the best price. But you didn't, you just went where it was convenient, and now you owe what you owe.

The difference is, even if you try to negotiate the cost up front all they'll say is "I dunno what it'll cost; we'll have to bill it and see what happens." Or if they do give you a number up front, it'll be wrong! And trying to shop around is useless -- if you even can shop around, which you can't when its an ER visit -- because every other damn place fails at quoting prices in the same way!

jackiechiles2

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Re: Anyone let a medical bill go to collections?
« Reply #12 on: March 08, 2016, 09:15:01 AM »
Oddly enough, for us, letting the bill go to collections helped us.  Let me explain.

We had a baby, had about a $5,000 max out of pocket that was met.  Half for baby half for mother.  With previous children, we'd call up the hospital, offer a payment plan of like $150, then after a few months, call them back and ask to pay 75% in a lump sum.  They'd always agree. Saved 25% of bill.

Apparently, the hospital has now changed their tactics.  Now, you either have to have a payment plan where you pay off the entire amount in 6 months, or let it go to collections.   They will not negotiate lower amounts.  I was planning on trying again, and forgot to pay the one for the baby, and that one went to collections. 

Collections people call me.  They immediately offer me the 75% lump sum payment deal.  They don't automatically put it on your credit either.  You've got like 30 days from date of original letter to accept the 75% deal and they don't report it to collections. 

I can't say I understand the hospital's logic here.  They'd rather pay a collections agency a percentage to take 75% when I was offering them 75% directly.   And we wonder why medical care is so expensive.

Lance Burkhart

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Re: Anyone let a medical bill go to collections?
« Reply #13 on: March 08, 2016, 09:16:30 AM »
I had a relatively small ER physician bill I refused to pay as a matter of principle that went to collections. Other than an occasional letter, I haven't been bothered by bill collectors about it. It hasn't aged off my credit report yet, but my credit score was over 700 anyway (medical derogatory marks don't count against you as much as non-medical ones).
Think of it this way. You bring your car into the dealership and say "change the tires and add break pads". You walk out and come back the next day, and they charge you $200 per tire and $100 per break pad plus $800 for install. So now you owe $2000 to the dealership. You then tell them "that's outrageous!, the repair shop down the street charges half that for the tires and installs them for free." You also pull out an expired coupon for half price on tire and break work at the dealership and show it to them. Do they have any obligation to charge you a lower price, something you find to be more fair? Sure, they could be nice and match prices with the other shop, or honor the coupon that is expired, but fact is you didn't mention any of those things up front, your coupon is expired, and you went to them for the work instead of another shop. Debating and trying to convince them is great, but at the end of the day just pay the bill.


The dealer paid for the tires and pads, paid for the work of the mechanic who put them on, and paid for the building and all the other expenses associated with the work. Stiffing them of payment is theft. I don't see your experience as some big different thing just because it was health care. You accepted actual goods and services, if you don't pay you are stealing.


Sure, health care is a racket and I'm not sympathetic to the clinic for charging you that much, but that is standard in all industries, you buy in bulk and you get a big discount, and that is what insurance companies do. They negotiate and pay a little as possible. And you could have got your vaccines at Walgreens or some other cheaper place, your job was to negotiate and find the best price. But you didn't, you just went where it was convenient, and now you owe what you owe.

I'm not trying to stiff them.  I offered them $800 which is probably double what I would've paid if insured.  They won't negotiate. 

I think your analogy breaks down for the reasons Jack says.   It turns out, according the biller I talked to on the phone yesterday, that the way to find out the prices is to go into the doctor's office and ask for the codes for what he wants to do before he does it, step out and call the billing department and ask the price.  This makes the doctor wait a lot longer during the visit and wives will have fighting children they have to control while on the phone.  Or she could get a babysitter.  You get the idea. 

Meanwhile, you have no idea how many times a particular charge will show up on the bill.  For example, they charged $229 for the doctor to walk into the room, and $63x4 for the shots, and another $125 to administer the oral.  "OH, YOU WANT THE DOCTOR TO DO SOMETHING WHEN HE WALKS IN INSTEAD OF JUST STAND THERE? THAT'LL COST YOU!"

AZDude

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Re: Anyone let a medical bill go to collections?
« Reply #14 on: March 08, 2016, 09:28:23 AM »
Basically, you did something stupid, and as a result someone decided to really screw you. Lesson learned. Next time get off your ass and sign up within the window.

Yeah, its ridiculous, but so is you not doing the extremely simple act of notifying your insurance of a qualifying event within 30 days.

jackiechiles2

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Re: Anyone let a medical bill go to collections?
« Reply #15 on: March 08, 2016, 09:48:24 AM »
I'm also somewhat sure they changed the ding your credit took for medical bills depending on the amount owed.

TheOldestYoungMan

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Re: Anyone let a medical bill go to collections?
« Reply #16 on: March 08, 2016, 11:08:16 AM »
I was fully insured.

The insurance company sent me the check.

The hospital never sent me a bill.  I called and asked for them to send me an address or an invoice or something.  I literally had like $6,000 just chilling in my checking account for over a year.

They would call every day.  I would say, give me an address, tell me who to make the check out to.  They wouldn't.

I eventually got sued.  I sent a copy of the letter from my insurance company saying they gave me 6k to pay the bill, with no info on how to pay it included.  I attached the copies of the 3 letters I sent to the hospital's general mailing address requesting an invoice or where to send the money.  I attached my bank statements for an entire year showing the money sitting in my checking account, balance never dropping below what was owed, money never used for anything else.  Sent that whole package to the judge, and he ordered them to send me an invoice.

They did.  I paid.

It sucked.  Stress for a year.

Altons Bobs

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Re: Anyone let a medical bill go to collections?
« Reply #17 on: March 08, 2016, 11:20:58 AM »
You were in the wrong, just pay the bill.

Cassie

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Re: Anyone let a medical bill go to collections?
« Reply #18 on: March 08, 2016, 03:26:07 PM »
I recently screwed up and called the wrong company for my cpap equipment. I called the old company. I then got a  bill for 375. It would have been free if I had used the right company. It was my mistake so I just paid.

ormaybemidgets

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Re: Anyone let a medical bill go to collections?
« Reply #19 on: March 08, 2016, 03:56:57 PM »
I'm not trying to stiff them.  I offered them $800 which is probably double what I would've paid if insured.  They won't negotiate. 

I think your analogy breaks down for the reasons Jack says.   It turns out, according the biller I talked to on the phone yesterday, that the way to find out the prices is to go into the doctor's office and ask for the codes for what he wants to do before he does it, step out and call the billing department and ask the price.  This makes the doctor wait a lot longer during the visit and wives will have fighting children they have to control while on the phone.  Or she could get a babysitter.  You get the idea. 

Meanwhile, you have no idea how many times a particular charge will show up on the bill.  For example, they charged $229 for the doctor to walk into the room, and $63x4 for the shots, and another $125 to administer the oral.  "OH, YOU WANT THE DOCTOR TO DO SOMETHING WHEN HE WALKS IN INSTEAD OF JUST STAND THERE? THAT'LL COST YOU!"

Right, but you didn't try to get the price in advance. No one quoted you the wrong price out of Big Medical greedy malice or ignorance. And no one told you that you would only be charged for one shot, instead of four (what are you saying here?), or that you didn't have to pay for the doctor's time in addition to the materials. YOU made the mistake. It sounds like you made several mistakes. There are problems with the healthcare industry, but YOU neglecting to put YOUR BABY on YOUR INSURANCE and then YOU not knowing that coverage would start on the 1st, is not one of the healthcare industry's problems.

Lance Burkhart

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Re: Anyone let a medical bill go to collections?
« Reply #20 on: March 08, 2016, 07:39:11 PM »
I had a relatively small ER physician bill I refused to pay as a matter of principle that went to collections. Other than an occasional letter, I haven't been bothered by bill collectors about it. It hasn't aged off my credit report yet, but my credit score was over 700 anyway (medical derogatory marks don't count against you as much as non-medical ones).

thanks buddy.

Lance Burkhart

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Re: Anyone let a medical bill go to collections?
« Reply #21 on: March 08, 2016, 07:42:08 PM »
I had a bill go to collections about 2 years ago.  It was for a procedure that the clinic estimated would cost total $2000, but then between us and the insurance company billed a total of $11,000.  After the insurance paid $9,000 of they sent us a bill for the remaining $2,000.

I called about it and they said they must have been some complication, but they could not explain what the complication was.  Following that I sent a certified letter requesting and explanation of the charges, and all they sent was the original bill, without even a cover letter acknowledging the dispute.  I sent another certified letter requesting and explanation of the charges, and that the accept the insurance company's $9,000 as payment in full.

About a year passed with no communication from the clinic, and eventually a collection notice came from a third party.  We sent them copies of all the past communications.  Several months later the amount was listed on my credit report as unpaid but disputed.  Credit score dropped from around 750 to 690, but during that time I was also doing some card churning.

I have not bothered trying to get it discharged from the credit report as I don't plan to get a mortgage within the next 7 years, and it hasn't affected my ability to card churn.

The clinic had to accept making only $9,000 (in spite of their 450% miss on the estimate).  Poor lambs!

Lance Burkhart

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Re: Anyone let a medical bill go to collections?
« Reply #22 on: March 08, 2016, 07:44:03 PM »
I was fully insured.

The insurance company sent me the check.

The hospital never sent me a bill.  I called and asked for them to send me an address or an invoice or something.  I literally had like $6,000 just chilling in my checking account for over a year.

They would call every day.  I would say, give me an address, tell me who to make the check out to.  They wouldn't.

I eventually got sued.  I sent a copy of the letter from my insurance company saying they gave me 6k to pay the bill, with no info on how to pay it included.  I attached the copies of the 3 letters I sent to the hospital's general mailing address requesting an invoice or where to send the money.  I attached my bank statements for an entire year showing the money sitting in my checking account, balance never dropping below what was owed, money never used for anything else.  Sent that whole package to the judge, and he ordered them to send me an invoice.

They did.  I paid.

It sucked.  Stress for a year.

There's a general war on competence going on in the US.  I bet it cost the provider well over $6k to take you to court too.

Lance Burkhart

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Re: Anyone let a medical bill go to collections?
« Reply #23 on: March 08, 2016, 07:51:37 PM »
Oddly enough, for us, letting the bill go to collections helped us.  Let me explain.

We had a baby, had about a $5,000 max out of pocket that was met.  Half for baby half for mother.  With previous children, we'd call up the hospital, offer a payment plan of like $150, then after a few months, call them back and ask to pay 75% in a lump sum.  They'd always agree. Saved 25% of bill.

Apparently, the hospital has now changed their tactics.  Now, you either have to have a payment plan where you pay off the entire amount in 6 months, or let it go to collections.   They will not negotiate lower amounts.  I was planning on trying again, and forgot to pay the one for the baby, and that one went to collections. 

Collections people call me.  They immediately offer me the 75% lump sum payment deal.  They don't automatically put it on your credit either.  You've got like 30 days from date of original letter to accept the 75% deal and they don't report it to collections. 

I can't say I understand the hospital's logic here.  They'd rather pay a collections agency a percentage to take 75% when I was offering them 75% directly.   And we wonder why medical care is so expensive.

The "75%" offer by collections might come from the fact that they buy the debt from the provider at 30-40 cents on the dollar.  Getting 75 cents from you (or me) allows them to make 100% profit.  I bet this initial offer is negotiable.  I've heard of other people waiting 120 days until it goes to collections and settling for 50% or waiting 9 months and settling for 20% (possibly with a second collection agency that bought the debt from the first).  A buddy at work got a call from some collections agent for a medical bill, told them how much cash he had on hand (about half the bill) and settled for that.

In selling the debt for 30-40 cents on the dollar, the providers still make out like bandits if they marked up certain things hundreds of percent like they've done for every bill I've ever gotten from a provider. 

The providers' decision to stop letting patients reduce bills probably comes from most patients starting to call up to reduce bills.  Like you said, now they just offer you a payment plan for 100% of their extortion.  They want to maximize profits.   

Primm

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Re: Anyone let a medical bill go to collections?
« Reply #24 on: March 08, 2016, 08:14:41 PM »
Meanwhile, you have no idea how many times a particular charge will show up on the bill.  For example, they charged $229 for the doctor to walk into the room, and $63x4 for the shots, and another $125 to administer the oral.  "OH, YOU WANT THE DOCTOR TO DO SOMETHING WHEN HE WALKS IN INSTEAD OF JUST STAND THERE knowing everything he has gained from a many-year medical degree and years and years of experience and passing that on to you and your family? THAT'LL COST YOU!"

There, fixed that for you.

An anaesthetist friend of mine puts it this way - "I don't get paid the big bucks to do the technical stuff. Any trained monkey can do that. I get the big bucks to keep you alive when the shit hits the fan. And more importantly, to stop the shit hitting the fan in the first place".

Same here. My electrician next-door-neighbour can be taught to give an injection. But trust me, if something goes wrong you want someone like me (a paediatric nurse with years of bringing kids back from the brink of death) or your paediatrician standing there. Not the electrician from next door, no matter how lovely he is.

You screwed up. Pay the bill, learn from the experience, don't do it again.

Lance Burkhart

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Re: Anyone let a medical bill go to collections?
« Reply #25 on: March 08, 2016, 08:43:24 PM »
Meanwhile, you have no idea how many times a particular charge will show up on the bill.  For example, they charged $229 for the doctor to walk into the room, and $63x4 for the shots, and another $125 to administer the oral.  "OH, YOU WANT THE DOCTOR TO DO SOMETHING WHEN HE WALKS IN INSTEAD OF JUST STAND THERE knowing everything he has gained from a many-year medical degree and years and years of experience and passing that on to you and your family? THAT'LL COST YOU!"

There, fixed that for you.

An anaesthetist friend of mine puts it this way - "I don't get paid the big bucks to do the technical stuff. Any trained monkey can do that. I get the big bucks to keep you alive when the shit hits the fan. And more importantly, to stop the shit hitting the fan in the first place".

Same here. My electrician next-door-neighbour can be taught to give an injection. But trust me, if something goes wrong you want someone like me (a paediatric nurse with years of bringing kids back from the brink of death)

Thanks for admitting your financial incentive to say things like this.  I'm not sure why you or anyone else advising me to pay sticker thought you were going to have an effect on my behavior since I never indicated I would pay sticker in the OP.  I guess you and the rest can keep telling me to pay if it feels good, meanwhile I'll continue to look forward to cost-saving innovations that will obviate many of these problems.  Might affect your employment in the long run though:
http://fortune.com/2012/12/04/technology-will-replace-80-of-what-doctors-do/ 

Primm

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Re: Anyone let a medical bill go to collections?
« Reply #26 on: March 08, 2016, 09:12:31 PM »
Meanwhile, you have no idea how many times a particular charge will show up on the bill.  For example, they charged $229 for the doctor to walk into the room, and $63x4 for the shots, and another $125 to administer the oral.  "OH, YOU WANT THE DOCTOR TO DO SOMETHING WHEN HE WALKS IN INSTEAD OF JUST STAND THERE knowing everything he has gained from a many-year medical degree and years and years of experience and passing that on to you and your family? THAT'LL COST YOU!"

There, fixed that for you.

An anaesthetist friend of mine puts it this way - "I don't get paid the big bucks to do the technical stuff. Any trained monkey can do that. I get the big bucks to keep you alive when the shit hits the fan. And more importantly, to stop the shit hitting the fan in the first place".

Same here. My electrician next-door-neighbour can be taught to give an injection. But trust me, if something goes wrong you want someone like me (a paediatric nurse with years of bringing kids back from the brink of death)

Thanks for admitting your financial incentive to say things like this.  I'm not sure why you or anyone else advising me to pay sticker thought you were going to have an effect on my behavior since I never indicated I would pay sticker in the OP.  I guess you and the rest can keep telling me to pay if it feels good, meanwhile I'll continue to look forward to cost-saving innovations that will obviate many of these problems.  Might affect your employment in the long run though:
http://fortune.com/2012/12/04/technology-will-replace-80-of-what-doctors-do/

Meh. That article (from 4 years ago, where have all the jobs gone? Oh yeah, they haven't) states more than 75% of the work doctors do can be replaced by RNs. That means more work for RNs, would you not agree?

Just as well that's my job then...

PS The author of that article? Principle at a company that provides venture capital for healthcare machines and technology companies. Hardly someone without a vested interest either, don't you think?
« Last Edit: March 08, 2016, 09:15:02 PM by Primm »

LeRainDrop

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Re: Anyone let a medical bill go to collections?
« Reply #27 on: March 08, 2016, 09:18:26 PM »
Is your family also prepared to find a new pediatrician?

Lance Burkhart

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Re: Anyone let a medical bill go to collections?
« Reply #28 on: March 08, 2016, 09:28:23 PM »
Meanwhile, you have no idea how many times a particular charge will show up on the bill.  For example, they charged $229 for the doctor to walk into the room, and $63x4 for the shots, and another $125 to administer the oral.  "OH, YOU WANT THE DOCTOR TO DO SOMETHING WHEN HE WALKS IN INSTEAD OF JUST STAND THERE knowing everything he has gained from a many-year medical degree and years and years of experience and passing that on to you and your family? THAT'LL COST YOU!"

There, fixed that for you.

An anaesthetist friend of mine puts it this way - "I don't get paid the big bucks to do the technical stuff. Any trained monkey can do that. I get the big bucks to keep you alive when the shit hits the fan. And more importantly, to stop the shit hitting the fan in the first place".

Same here. My electrician next-door-neighbour can be taught to give an injection. But trust me, if something goes wrong you want someone like me (a paediatric nurse with years of bringing kids back from the brink of death)

Thanks for admitting your financial incentive to say things like this.  I'm not sure why you or anyone else advising me to pay sticker thought you were going to have an effect on my behavior since I never indicated I would pay sticker in the OP.  I guess you and the rest can keep telling me to pay if it feels good, meanwhile I'll continue to look forward to cost-saving innovations that will obviate many of these problems.  Might affect your employment in the long run though:
http://fortune.com/2012/12/04/technology-will-replace-80-of-what-doctors-do/

Meh. That article (from 4 years ago, where have all the jobs gone? Oh yeah, they haven't) states more than 75% of the work doctors do can be replaced by RNs. That means more work for RNs, would you not agree?

Just as well that's my job then...


Until they figure out that 75-80% of what you do can be replaced by software and a robot, yes. 

At work I always shake my head at the hubris of people who say they're irreplaceable because I've seen so many later laid-off.  I'm replaceable; you're replaceable.  When there's no more money to squeeze out of patients or the government, the executives start cutting costs.  Gotta return value to the shareholder, and usually executives hold millions worth of restricted shares. 

I'm sure you're right though, I should just pay whatever these conglomerate providers demand, especially when it will pay the salaries of meddling scolds.   

Lance Burkhart

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Re: Anyone let a medical bill go to collections?
« Reply #29 on: March 08, 2016, 10:34:24 PM »
BTW I forgot to mention this is the provider:
http://www.sfgate.com/bayarea/article/Sutter-Health-accused-of-fraud-by-state-2375081.php

Sutter settled the hundreds of millions down to $46 million. They DO settle with people!
http://www.lieffcabraser.com/Case-Center/Sutter-Hospital-Fraudulent-Billing-Qui-Tam-Lawsuit.shtml

 I'm sure they were only fraudulently billing for anaesthesia services and not other services though.

Quote
In addition, Sutter Health agreed to a comprehensive series of billing and transparency reforms, which California Insurance Commissioner Dave Jones called a groundbreaking step in opening up hospital billing to public scrutiny.
If ever there were something that needed exposure to light...


LeRainDrop

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Re: Anyone let a medical bill go to collections?
« Reply #30 on: March 08, 2016, 10:45:09 PM »
Meanwhile, you have no idea how many times a particular charge will show up on the bill.  For example, they charged $229 for the doctor to walk into the room, and $63x4 for the shots, and another $125 to administer the oral.  "OH, YOU WANT THE DOCTOR TO DO SOMETHING WHEN HE WALKS IN INSTEAD OF JUST STAND THERE knowing everything he has gained from a many-year medical degree and years and years of experience and passing that on to you and your family? THAT'LL COST YOU!"

There, fixed that for you.

An anaesthetist friend of mine puts it this way - "I don't get paid the big bucks to do the technical stuff. Any trained monkey can do that. I get the big bucks to keep you alive when the shit hits the fan. And more importantly, to stop the shit hitting the fan in the first place".

Same here. My electrician next-door-neighbour can be taught to give an injection. But trust me, if something goes wrong you want someone like me (a paediatric nurse with years of bringing kids back from the brink of death)

Thanks for admitting your financial incentive to say things like this.  I'm not sure why you or anyone else advising me to pay sticker thought you were going to have an effect on my behavior since I never indicated I would pay sticker in the OP.  I guess you and the rest can keep telling me to pay if it feels good, meanwhile I'll continue to look forward to cost-saving innovations that will obviate many of these problems.  Might affect your employment in the long run though:
http://fortune.com/2012/12/04/technology-will-replace-80-of-what-doctors-do/

Meh. That article (from 4 years ago, where have all the jobs gone? Oh yeah, they haven't) states more than 75% of the work doctors do can be replaced by RNs. That means more work for RNs, would you not agree?

Just as well that's my job then...


Until they figure out that 75-80% of what you do can be replaced by software and a robot, yes. 

At work I always shake my head at the hubris of people who say they're irreplaceable because I've seen so many later laid-off.  I'm replaceable; you're replaceable.  When there's no more money to squeeze out of patients or the government, the executives start cutting costs.  Gotta return value to the shareholder, and usually executives hold millions worth of restricted shares. 

I'm sure you're right though, I should just pay whatever these conglomerate providers demand, especially when it will pay the salaries of meddling scolds.   

Dude, you should pay the bill because they provided precisely the services you requested and charged you the correct price for a patient who was not covered by insurance at the time the services were rendered.  You made the mistakes, not them.  They fulfilled their end of the bargain, and now you should fulfill yours.  I think it's still worth trying the mea culpa strategies that James explained so well, but in the end, if they won't budge, it falls on you.  If you're just flat out not willing to pay what you owe, then perhaps you should be posting on a forum for swindlers.  This forum is for people who are frugal with their spending choices, not people who after receiving the benefit of their bargain simply decide they are going to unilaterally demand a renegotiation of that bargain.

Kenbo

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Re: Anyone let a medical bill go to collections?
« Reply #31 on: March 08, 2016, 11:43:59 PM »
I could probably rant on about several of the previous mentioned aspects.  To the original query though you could probably save money by settling with a collections agency at the cost of a credit ding if the care provider is unwilling.  Your principles are going to determine if that's acceptable to you.  The fact is expenses for some patients are never recovered.  The hospitals have to write them off as a loss which means increasing charges to keep the ability to operate where they can.  You can probably save a buck in the short term but in the long run it's contributing to part of the problem of medical costs. 

gooki

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Re: Anyone let a medical bill go to collections?
« Reply #32 on: March 09, 2016, 02:07:22 AM »
Fucking hell, those charges are criminal. Are there no consumer protection laws that prevent predatory pricing in the USA?

thingamabobs

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Re: Anyone let a medical bill go to collections?
« Reply #33 on: March 09, 2016, 02:13:25 AM »
So in the original post you asked how much interest you would have to pay if you paid up as soon as the bill goes to collection. Assuming the collection agency will want to collect the full amount for maximum profit and given your already stated stance that you're not willing to pay the sticker price, you are not going to be reaching a compromise easily. How much of a discount is going to be worth your time and aggravation?

Nickels Dimes Quarters

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Re: Anyone let a medical bill go to collections?
« Reply #34 on: March 09, 2016, 05:44:42 AM »
Pay it.

NDQ

James

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Re: Anyone let a medical bill go to collections?
« Reply #35 on: March 09, 2016, 10:46:34 AM »
I think your analogy breaks down for the reasons Jack says.   It turns out, according the biller I talked to on the phone yesterday, that the way to find out the prices is to go into the doctor's office and ask for the codes for what he wants to do before he does it, step out and call the billing department and ask the price.  This makes the doctor wait a lot longer during the visit and wives will have fighting children they have to control while on the phone.  Or she could get a babysitter.  You get the idea. 

Actually, my analogy is quite good if you ask me, I know specific examples of car dealers screwing people over with obscene charges and taking all sorts of liberties with adding fees and work to people just wanting a simple car repair. The difference is that car dealers are getting better because they are being forced to. What happens now is that you are given an estimate and asked to sign it, and you are told that if they go much higher they will call you. Prices in auto repair in general have become more public, sometimes even posted on the wall over their heads or on their web sites. You can know the hourly rate of the mechanics, ask them to call if going above a certain dollar amount, etc. But these are all pretty new, 10-20 years ago auto repair was much worse, and car dealers were notorious for their obscene prices and additions. Certainly not all of them, but plenty of them.

My point is that health care is in a similar situation right now, with the additional complexity of insurance companies and government payments pushing their payments down, on top of patient demand for the absolute best and absolute safety. So yes, you absolutely got screwed by the charges. And yes, you absolutely can't easily compare prices and shop around at many places. But people who just show up and flow through the system are the PROBLEM. If more people asked for prices, demanded transparency, and shopped around, then health care providers would adapt.  I'm not saying it is right, I'm saying this is how it is, so adapt, and pay the charges if you can afford them. Not because the charges or right and fair, but because paying them is the right thing to do.

What is so sad is that other options are completely ignored, even after I mentioned them. You talk about how hard it would be to get estimates from the clinic, so fuck them. Go ask Walgreens or your other local vaccine places. I agree clinics and hospitals are a pain in the ass, so if paying cash I would avoid them whenever possible. I'm not faulting you for not knowing to do that ahead of time, but I think it is fair to acknowledge there are other options besides just going with the high cost unknown route. And that is on us the consumers to spread the word and make those choices. We aren't fucking sheep, we can figure things out and work with the system to lower costs. And when we don't we can pay the price and encourage the status quo.

But obviously you will do what you want, I'm not following the thread anymore, just wanted to make my opinion clear. The system is fucked up, you got fucked by the system. But the answer isn't to cheat, the answer is to pay up, learn from your mistake, and fight to support those who are doing it right within the system. Share your experience on Facebook and suggest others learn from your mistakes. If paying cash everyone should know you can't just show up and expect to pay a fair amount, there are other options and you can save a huge amount using them.

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LeRainDrop

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Re: Anyone let a medical bill go to collections?
« Reply #37 on: March 09, 2016, 01:17:14 PM »
1.  If the bill goes to collections, will collections try to collect ALL of it or some fraction? How much interest will they ask for if I pay the minute it goes to collections (usually this doesn't happen until being 120 days delinquent).

The interest rate is probably identified on the statement that they sent you.  Maximum interest would determined by your state's laws.  In Georgia, this would be a commercial account, which by statute incurs interest at a rate of 1.5% per month, which equals 18% annually.

Noahjoe

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Re: Anyone let a medical bill go to collections?
« Reply #38 on: March 09, 2016, 02:47:35 PM »
I'm compelled to respond, because I happen to work in healthcare revenue cycles. Have you thought about applying for charity care discounts? Depending on your situation, you may qualify. It varies per organization, and almost all of them have some kind of self pay discount. The department you need to talk to is typically different from the ones trying to collect or receive your payment, so you'll have to ask for them. Financial Services, Financial Counseling, Patient Financial Counseling, you get the idea.

Depending on how far off the Federal Poverty Line you are, your discount may be more than you're asking for unqualified.

http://www.sutterhealth.org/about/ab_uninsured.html


In February 2004, Sutter Health affiliates adopted a common, systemwide charity care policy. As part of this policy, uninsured patients with annual incomes below 200 percent of the Federal Poverty Income Level ($46,100 a year for a family of four - 2012 FPIG) may qualify to receive free care. Uninsured patients with annual incomes between 200 and 400 percent of the FPIG ($46,100-$92,200 a year for a family of four - 2012 FPIG) are billed at rates well below those charged to private insurance companies. No uninsured patient, regardless of their financial status, will receive a bill for full-billed charges at a Sutter hospital.

In March 2006, Sutter Health adopted a new policy for all of our affiliated hospitals that provides for those facilities to offer automatic discounts to uninsured patients. These discounts are comparable to the negotiated discounts that the hospitals provide to private insurance companies. Sutter Health also provides catastrophic protection to low-income uninsured patients by limiting their payment liability to 30 percent of their annual household income.

Capsu78

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Re: Anyone let a medical bill go to collections?
« Reply #39 on: March 09, 2016, 04:48:26 PM »
Make a $5 payment on the bill every 119 days to reset the aging.

Lance Burkhart

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Re: Anyone let a medical bill go to collections?
« Reply #40 on: March 11, 2016, 08:57:23 AM »
James,

Great post and I'm weighing just paying it versus collections which is why I'm asking about the consequences of letting it go to collections. But your post probably pushed me in the direction of just paying it.  Patients like me do need to start asking a lot more questions and stop assuming good faith by these conglomerate providers. 

I called a billing advocate but my bill was too small for him to want to deal with it. 

The other day I took my dog to the vet without an appointment.  Within 10 minutes, without asking, the vet himself produced an estimate and came in under the estimate.  By contrast, I talked to a friend the other day who went into a Sutter doctor with his wife for their free wellness visit covered by their insurance.  They scheduled it as a wellness visit and the provider agreed to it.  They have a HDHP.  Due to some note the doctor made, the biller coded it as a regular doctor visit.  My friend just paid it.  His wife refuses.  They switched to Kaiser.  I'll switch providers also.

Maybe I'll ask the vet if he can treat me next time.  I bet he could've stitched my ankle laceration just as well as the urgent care. 

Thanks to all others who replied, especially those who replied to the OP. 


James

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Re: Anyone let a medical bill go to collections?
« Reply #41 on: March 24, 2016, 07:05:56 AM »
James,

Great post and I'm weighing just paying it versus collections which is why I'm asking about the consequences of letting it go to collections. But your post probably pushed me in the direction of just paying it.  Patients like me do need to start asking a lot more questions and stop assuming good faith by these conglomerate providers. 

I called a billing advocate but my bill was too small for him to want to deal with it. 

The other day I took my dog to the vet without an appointment.  Within 10 minutes, without asking, the vet himself produced an estimate and came in under the estimate.  By contrast, I talked to a friend the other day who went into a Sutter doctor with his wife for their free wellness visit covered by their insurance.  They scheduled it as a wellness visit and the provider agreed to it.  They have a HDHP.  Due to some note the doctor made, the biller coded it as a regular doctor visit.  My friend just paid it.  His wife refuses.  They switched to Kaiser.  I'll switch providers also.

Maybe I'll ask the vet if he can treat me next time.  I bet he could've stitched my ankle laceration just as well as the urgent care. 

Thanks to all others who replied, especially those who replied to the OP.


I work for a large health care organization, and believe me if you write the CEO a letter detailing your visit and the information from your friends, they will absolutely care. Not saying they will make changes right away, but this sort of information freaks health care administrators out. I attend our provider meetings and there is a focus every time on why people leave and making sure they don't. Providing transparency in billing is always discussed, and it is getting better because people are starting to complain and leave. Be that person, don't go quietly, what people say as they leave is almost more importantly than the leaving itself.

Lance Burkhart

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Re: Anyone let a medical bill go to collections?
« Reply #42 on: December 19, 2016, 10:43:50 PM »
Thanks James.

I ended up paying half and telling the lady at the billing office I wouldn't be paying more and she could send it to collections if they wanted.  She said Sutter doesn't send bills to collections.  I forked over $650 and never heard from them again. 

I still use Sutter.  They seem to like me as a customer.  As long as I treat their billing the department the same way it treats me, everyone's expectations are at the same level.