mzaslavsky
Junior Member
What is the name of your state (only U.S. law)? MA
This is a long story, so thanks a lot in advance for patience to read all the stuff below. I received a medical service in the beginning of 2011, however, my insurance didn't receive any bill from the doctor's office till the end of 2012. My insurance company issued an explanation of benefits saying that I owe $200.
That was rather surprising for me since I reached out of pocket maximum for 2011, according to my insurance plan. Once I received explanation of benefits I followed what was written there how to dispute it. My first dispute was rejected, and the second one was left unanswered. Then I called my insurance company, and representative explained me that they look if out pocket maximum was reached at the date of service. If not then the insurance doesn't cover the bill in full. OK, that is fine, but I explained that the insurance company was not aware of the bill till the end of 2012, and my out of pocket maximum was reached paying for other expenses. Representative just said that an audit has to requested in this case, and it will take a month or so, and that I'll receive the results by regular mail. It looks like for all these people summing up mu expenses for 2011 is too difficult task.
OK, I requested an audit, but didn't receive anything for two months. I called them again, but representative told me that an audit was not completed yet, that I have to talk to the person who requested an audit, that she is not available now, and that she will call me later. No calls for a week... I'm calling the insurance again... At that time representative told me the audit was not completed yet (of course!) because they didn't know what precisely to audit for! But then in a few minutes of holding, she said that the checked my account by herself (looks like that was the only person who can use calculator) and agreed that i own nothing. She promised to correct my explanation of benefits in a couple of days and send the payment to doctor's office. Now, a week after, explanation of benefits was not corrected - not sure if the payment was sent.
OK, but that is not my major problem. A major one is that I received a call (and then a letter, after I called back) from debt collector (MBROI). In fact, it is already 9 months after my insurance received a bill from the doctor's office. All this was complicated by the fact that doctor didn't have my current address (since 2011 I moved from my old place). Therefore, all the mail from doctor's office was returned, and, technically speaking, I never received any bill.
So, main question here is how to behave in this case properly not to damage my credit score? Does anybody know what is MBROI? Is it hospital affiliated debt collector how can't affect credit score or it outside collector who can? Does it make sense to record all the phone calls to avoid any false promises from either side - from debt collector (say, promise, not to damage my credit score), from insurance company? Also, in the worst case scenario, if my credit score will be damaged, is there any way to sue anybody to put my credit score back (or to receive any compensation)? I really work hard to keep my credit score high, and don't want anyboby to damage it this ridiculous way!
This is a long story, so thanks a lot in advance for patience to read all the stuff below. I received a medical service in the beginning of 2011, however, my insurance didn't receive any bill from the doctor's office till the end of 2012. My insurance company issued an explanation of benefits saying that I owe $200.
That was rather surprising for me since I reached out of pocket maximum for 2011, according to my insurance plan. Once I received explanation of benefits I followed what was written there how to dispute it. My first dispute was rejected, and the second one was left unanswered. Then I called my insurance company, and representative explained me that they look if out pocket maximum was reached at the date of service. If not then the insurance doesn't cover the bill in full. OK, that is fine, but I explained that the insurance company was not aware of the bill till the end of 2012, and my out of pocket maximum was reached paying for other expenses. Representative just said that an audit has to requested in this case, and it will take a month or so, and that I'll receive the results by regular mail. It looks like for all these people summing up mu expenses for 2011 is too difficult task.
OK, I requested an audit, but didn't receive anything for two months. I called them again, but representative told me that an audit was not completed yet, that I have to talk to the person who requested an audit, that she is not available now, and that she will call me later. No calls for a week... I'm calling the insurance again... At that time representative told me the audit was not completed yet (of course!) because they didn't know what precisely to audit for! But then in a few minutes of holding, she said that the checked my account by herself (looks like that was the only person who can use calculator) and agreed that i own nothing. She promised to correct my explanation of benefits in a couple of days and send the payment to doctor's office. Now, a week after, explanation of benefits was not corrected - not sure if the payment was sent.
OK, but that is not my major problem. A major one is that I received a call (and then a letter, after I called back) from debt collector (MBROI). In fact, it is already 9 months after my insurance received a bill from the doctor's office. All this was complicated by the fact that doctor didn't have my current address (since 2011 I moved from my old place). Therefore, all the mail from doctor's office was returned, and, technically speaking, I never received any bill.
So, main question here is how to behave in this case properly not to damage my credit score? Does anybody know what is MBROI? Is it hospital affiliated debt collector how can't affect credit score or it outside collector who can? Does it make sense to record all the phone calls to avoid any false promises from either side - from debt collector (say, promise, not to damage my credit score), from insurance company? Also, in the worst case scenario, if my credit score will be damaged, is there any way to sue anybody to put my credit score back (or to receive any compensation)? I really work hard to keep my credit score high, and don't want anyboby to damage it this ridiculous way!
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