Legal Question in Credit and Debt Law in California

Medical Bill Collection Already Paid by Insurance per Providers' contract

Hi,

Thanks in advance for answering my question. In November of 2002, I visited a Dr. who was a preferred provider in my employer's insurance company network. The insurance company paid the Dr. visit at 100% of the contracted amount. Yet the Dr. has send me a bill for the remainder and has sent that bill to collection agency.

The collection agency sent me letter of collection and stated that if you don't dispute this bill we assume it is valid and pursue collection process. I disputed the bill by sending them a letter from my insurance company which states I'm not liable for this balance. But apparantly they ignored my letter tnd now they have started collection process.

I've also talked to the Dr. regarding removing his collection claim, but he has not been cooperative.

What are my legal options here? If the collection goes to my credit it will damage my credit and it'll be costly. How can I stop the collection company and the Dr. which apparently ignore my letters.

Thanks so much,

Sean


Asked on 8/07/03, 6:53 pm

1 Answer from Attorneys
Ken Koenen Koenen & Tokunaga, P.C.

Re: Medical Bill Collection Already Paid by Insurance per Providers' contract

Send the doctor a letter, with a copy to the collection agency. Let him know that if he does not resolve the problem within 10 days, you will be filing a complaint about him with the insurance company.

They do not like it when a doctor tries to charge more than the contracted rate, and could remove him as a preferred provider. That could cost him a lot of business.

If he does not respond, you will need to follow through with that threat, and possibly take further action against him and the collection agency.

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Answered on 8/07/03, 7:21 pm


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