Fairness in Collecting Medical Bills

[Duke2Earl]

They wont take it to court.
They said they would simply report me to the credit agencies as delinquent and ruin my credit.

And you can dispute their claim at the credit agencies. I don't know what the rest of your credit situation is but one disputed claim from a single doctor will hardly "ruin your credit" if all else is on time.

[Lambkin]

I'd tell them that it is as big a surprise to you that your insurance didn't cover the entire amount, and that you will make regular payments to satisfy the balance, if they pursue the 35% interest and report you to a credit agency, then you are very sorry that they treat their patients this way and will seek care from another provider, as well as tell everyone you know to avoid their office like the plague.

I find that retailers are usually less than delighted to learn that you'll throw a "word-of-mouth" party to inform 100 of your closest friends about what jerks they are. Any sensible retailer knows that 1 angry customer tells a lot more of their friends than 50 happy customers.

I once worked at a retailer that had an angry customer take out a 1/4 page ad in the local paper detailing the company's transgressions. This wasn't a welcome development for a small business owner.

It's pretty surprising to hear this kind of crap from a medical provider regarding a client who is willing to pay eventually. Usually they are happy to get paid ever and don't overly antagonize people who are cooperative and making payments.

[ErsatzAnatchist]

The good Dr. may not be covered by Truth-In-Lending if he does not regularly extend credit:

15 USC Sec. 1602:

f) The term "creditor" refers only to a person who both (1) regularly extends, whether in connection with loans, sales of property or services, or otherwise, consumer credit which is payable by agreement in more than four installments or for which the payment of a finance charge is or may be required, and (2) is the person to whom the debt arising from the consumer credit transaction is initially payable on the face of the evidence of indebtedness or, if there is no such evidence of indebtedness, by agreement. Notwithstanding the preceding sentence, in the case of an open-end credit plan involving a credit card, the card issuer and any person who honors the credit card and offers a discount which is a finance charge are creditors. For the purpose of the requirements imposed under part D of this subchapter and sections 1637(a)(5), 1637(a)(6), 1637(a)(7), 1637(b)(1), 1637(b)(2), 1637(b)(3), 1637(b)(8), and 1637(b)(10) of this title, the term "creditor" shall also include card issuers whether or not the amount due is payable by agreement in more than four installments or the payment of a finance charge is or may be required, and the Board shall, by regulation, apply these requirements to such card issuers, to the extent appropriate, even though the requirements are by their terms applicable only to creditors offering open-end credit plans. Any person who originates 2 or more mortgages referred to in subsection (aa) of this section in any 12-month period or any person who originates 1 or more such mortgages through a mortgage broker shall be considered to be a creditor for purposes of this subchapter.

I stand by my original statement that the Doctor is covered by the truth in lending act.

Credit is defined as: "Credit means the right to defer payment of debt or to incur debt and defer its payment."

For credit which is not secured by a debtor's principal residence, the term regularly extends credit is defined as: "A person regularly extends consumer credit only if it extended credit . . . more than 25 times . . . in the preceding calendar year."

Assuming that the Doctor had at least 25 patients who did not pay in full in the prior year, the Doctor is covered by Truth in Lending.

[Kimokeo]

Too bad you're not an illegal immigrant. They don't have to pay.

I bet if you took your complaint to Admiralty Court, you'd win.

[gottago]

I don't think that most doctors, other than those who perform cosmetic procedures, consider themselves to be in the credit business. Having worked in several medical practices, I have seen first hand how difficult it is to collect payment for services rendered that are not covered by insurance. It is a simple fact that, except for entitlement programs like Medicaid, patients are required to pay a share of the costs of the treatment they receive. Sometimes patients do not understand their insurance and what it pays, sometimes they lie about having coverage and sometimes they think the doctor should just settle for what the insurance pays and "write the rest off".

Like any other business, a medical practice has rent, utilities, payroll, supplies, equipment etc. Doctors also pay huge malpractice premiums, licensing fees, continuing education fees and are the only professionals (including dentists, chiropractors, therapists, etc.) who are primarily reliant on a third party payer system and a sense of entitlement among their customers. I am sure others of you on here who are in business for yourself do not do work without payment or extend open ended, free credit to those you do work for. I would think that the 35% interest rate would be more of a tactic to encourage bill payment. Sending an account to collections is expensive and rarely done unless a large amount of money is involved.

Unless your procedure was a critical, life threatening emergency then it is your responsibility to arrange payment as quickly as possible since you should have determined what the cost to you would be before receiving the service.

Just my opinion...

[Imalawman]

I don't think that most doctors, other than those who perform cosmetic procedures, consider themselves to be in the credit business. Having worked in several medical practices, I have seen first hand how difficult it is to collect payment for services rendered that are not covered by insurance. It is a simple fact that, except for entitlement programs like Medicaid, patients are required to pay a share of the costs of the treatment they receive. Sometimes patients do not understand their insurance and what it pays, sometimes they lie about having coverage and sometimes they think the doctor should just settle for what the insurance pays and "write the rest off".

Like any other business, a medical practice has rent, utilities, payroll, supplies, equipment etc. Doctors also pay huge malpractice premiums, licensing fees, continuing education fees and are the only professionals (including dentists, chiropractors, therapists, etc.) who are primarily reliant on a third party payer system and a sense of entitlement among their customers. I am sure others of you on here who are in business for yourself do not do work without payment or extend open ended, free credit to those you do work for. I would think that the 35% interest rate would be more of a tactic to encourage bill payment. Sending an account to collections is expensive and rarely done unless a large amount of money is involved.

Unless your procedure was a critical, life threatening emergency then it is your responsibility to arrange payment as quickly as possible since you should have determined what the cost to you would be before receiving the service.

Just my opinion...

So you're saying, take responsibility for what you owe and start paying it? No comment.

[The Observer]

Since gottago has taken responsibility for her taxes and has seriously taken steps to deal with the situation, I don't think we need to dig up that dead horse.

[Imalawman]

You're probably right. I just thought it a bit "pot calling the kettle black" to be so harsh about paying the medical bills, when AFTP has stated that he/she intends to pay the bill in full. Just rubbed me the wrong way. Sorry if that was a bit tetchy.

[Quixote]

Unless your procedure was a critical, life threatening emergency then it is your responsibility to arrange payment as quickly as possible since you should have determined what the cost to you would be before receiving the service.

If the procedure was routine, there was no hospital involved, and the doctor had a set fee, you are right. Otherwise, it is often difficult to determine beforehand what the cost will be and who is responsible for paying it. Hospitals, in particular, are reluctant to quote a price.

[gottago]

That is because the price charged by the doctor or hospital is different for each patient, even those receiving the exact same treatment. It completely depends on the insurance coverage.

For example, some insurance pays 80% of the actual charges with 20% of the actual charges collected from the patient. If the insurance has a PPO type arrangement with the provider, the doctor/hospital is paid what the insurance company determines is "customary and usual" for the services and they can not collect the balance from the patient, although there is sometimes a copay collected at the time of service.

If the insurance is Medicaid the provider is paid by a set fee schedule for the service, period. If the patient is uninsured, they are charged the actual charges. Some doctors and hospitals will offer a discount if the charges are paid in full in cash at the time of service.

Typically, ER's are the only places uninsured patients can receive treatment without paying at least something at the time of service. An ER can not turn any patient away if they present themselves for care. They are still billed by the ER but many are unable to/don't pay and they could care less about their credit rating. The uninsured are usually better off in a large metropolitan area since there is often subsidized (free to them) care provided by a county hospital district utilizing clinics and other outpatient facilities.

In practice, every doctor I have worked with provides some free care. I myself have seen many established patients who have lost their insurance coverage and have no money. Sometimes it is kids in the same family and only some of them have coverage but they are all sick. Drug samples are a wonderful thing in these cases. I simply write "no charge" on the bill, make a medical record and that's it. Every doc I have ever worked with has left this completely to my discretion.

[RyanMcC]

I went to the dentist yesterday, they were also reluctant to quote a price, the secretary has to punch info into a computer before they quote a price. $1,500 to pull 4 wisdom teeth. Calculating who will pay is simple as I don't have any insurance..

If I did have insurance, I think a thing or two quoted probally wouldn't have been covered so it can be difficult to determine at the doctors office who pays what.

Luckly I can pay it without any trouble, they did mention payment plans also but like in this instance they probally do charge intrest (although they didn't mention intrest).

--

My course of action would be to simply pay the bill with intrest and put up a website (ThisDoctorSucks.Com) and let them know about it afterwards (or let them find it themselves when they google their name). Say on the website they should be up-front about the intrest.

You may want to put up the website first, tell them you put the website up because you feel the intrest is unfair and they should have disclosed it up front. Then give them the option of accepting payment in full at no (or more reasonable) intrest thus satisfying your complaint, or that you can pay the full price they request and leave the website up for the next few years (at $6.50/yr for a domain name it's cheap, particularly if you can find free hosting). That is assuming you no longer wish to use this doctor and don't mind them being upset with you. As long as the statements on the website are truthful there should be no problems in doing so. They may even mistakingly think they have a case against you (they wouldn't if it's a legitmate consumer complaint) and take you to court, thus allowing you to bring up your other matter. I could cite a number of cases where companies have sued people for putting up *sucks.com websites, and lost.

The owner of a company I made such a website about once called me and mentioned a lawsuit in passing, I laughed out loud, posted on my website 5 previous court cases where the plaintiff failed to win the case under the same circumstances, he then dealt with my complaint, I took down the website, and everyone was happy. I wanted nothing from them other than for them to acknowledge my complaint, so it was easy for them to comply, the owner even thanked me afterwards. (I had a problem with one of their managers, since he could successfully block any complaints easily I put up the website).

State only facts on the website, not being emotional. Then present it to the doctors office unemotionally like it is a simple business decision. Either offer a more fair rate and disclose it to your patients up front in the future, or allow this website to stay online for the next few years.

As I said I'd just pay the bill and put the website up, thus not giving the doctor a choice and avoiding all confrontation and teaching him a lesson the hard way. While they may legally have the option of charging high intrest rates and not disclosing it up front, you certainly have the option of complaining about it and putting up any website you wish to do so.

I've actually gotten a company or two to change their policy on certain issues via this method. I made such a website just last week about a radio talk show host, just to make him consider more carefully the things he says on the air which are untrue..

This is only an option. There may be better ways of handling it.. Hopefully you can come up with a better idea, or someone here can suggest a better one.

I'm not sure I'd handle this particluar situation in this manner, but it may be something to consider..

Best of luck. Hope you get your issue solved.

[AFTP]

I received an application for a reduction of the bill. I just need to send in my 1040. But I think the 35% is a crime.
I’m still waiting for a call from my States consumer fraud division.
I spoke to another Doctor’s billing office today and was told they never heard of charging 35% and calling it delinquent if payments are being made.