Legal Question in Credit and Debt Law in California
Payment for unreimbursed medical fees
Received chiropractic treatment over 3 year period. Insurance copayments were paid when requested. The chiropractor billed my insurance. My insurance reimbursed chiropractor for a portion of fees. I received statements from my insurance with amounts chiropractor was reimbursed. Chiropractor and office staff, when questioned about payment of unreimbursed portions (numerous times during course of my treatment), indicated no payment was necessary. No invoice was ever received from chiropractor requesting payment of the unreimbursed portions. Chiropractor has now (two years since my last visit) demanded payment in full of unreimbursed amounts. I received a certified letter demanding immediate payment and threatening collections. Several other past-patients also received the same demand letter. None of the other past-patients had ever received an invoice from the chiropractor and all were similarly told that they owed nothing during the course of treatment. Chiropractor is now denying ever making any statements forgiving the unpaid portions and is stating that we should have known we needed to pay the unreimbursed amounts. Had I been advised that the unreimbursed portions where due, I would have immediately stopped seeing him.
3 Answers from Attorneys
Re: Payment for unreimbursed medical fees
The very last thing that I would recommend is bankruptcy.
Who was your medical insurance through? In many cases, the doctors have a contract with the insurance company that determines 1) what the co-payment is, 2) the amount that the insurance company will pay, and 3) that the patient is not responsible for any more than that. If your insurance company had this kind of contract, then you are a 3rd party beneficiary of that contract, and it would protect you.
There are some other arguments that you could make in defense of this. How much is involved? Sometimes a good offense is the best defense. Perhaps a letter from an attorney will carry more weight than a letter or call from you. Unfortunately, sometimes this is the only thing people understand.
A threatening letter sent by certified mail often makes people think that they are in a weak position, when in reality they might be in a very strong position.
Re: Payment for unreimbursed medical fees
This sounds like quite a racket your chiropractor has going. It is clear that neither you, nor the other similarly placed patients of this chiropractor, owe him anything. You should notify him of your position in writing of your position, and if he goes forward you will defend any action he may take, and that you will cross-complain for fraud. You'd have the right to do so.
Re: Payment for unreimbursed medical fees
Thanks for your posting. Payment for services in the medical setting is normally set by contract, so it is important to read anything you may have signed carefully, as it might be controlling.
Having said that, you may have a modification of any contract by the person or person treating you promising you that you would not be billed. You should have confirmed that in writing somehow, or obtained a witness, but if you didn't, the question becomes whether or not that person had the ability to promise that you were being treated for free, and that they did not expect payment for their services.
Remember two things also:
1. Everything is negotiable; and
2. You can always declare bankruptcy on this debt.
They may sue you for this, but the above two points may keep you from worrying too much about this, and if you try everything you can before you get sued, you will save a lot of backtracking later.
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