Medical False statements or representation attempted to collect wrong amount
Medical Data Systems, Inc. Debt collection department,
On -/-/2017 i called - to check on the status of an insurance payment and was directed to call the collection agency for that information. I explained this is for a recent claim submission. The - rep said I needed to speak with the collection agency and they have access to all of the same information - does. I then contacted Medical Data Systems regarding a debt that was placed with them. They do not own this debt. I explained i was calling to verify the claim status of a retroactive insurance payment for this account. The representative informed me that the balance was now $2800.00. I stated, that was the original balance and the hospital adjusted the balance because of their contractual agreement with -. She said well they denied the claim. I explained to her that the hospital billed - and thats why it was denied and - iis who needs to be billed. I explained to her I had just spoken with the hospital and the - who is responsible for - and - said I needed to make sure the claim was submitted. The Med Data - said it was submitted and they denied the claim.
community Health and they have informed me that I have coverage for this day and the claim needs to be submitted to them. The rep said insurance will not pay claims outside of 6 months. I said, again I have already spoken with - ( the - rep told me to inform - and MDS they have 6 months from the Retro approval date to submit the claim ) and was informed the hospital has 6 months from -/-/- to send this for payment. She said they already denied it. I called - again and spoke with - Ref # - and she said that was not true and MDS needs to contact - because they are trying to collect for - and claim details can not be discussed with the consumer. I called MDS back & was told " we do n't do that '' I argued and she said you dont have proof you have coverage. I said Yes I do. ( I could hear the supervisor in the background saying '' is that that medicaid lady calling again '' She said fine, send your proof to my supervisor at -. I sent proof. I called - that evening and was informed the claim had not been submitted yet. They had just submitted it that evening. On -/-/- I checked the claim and - payed it so I checked my credit score, MDS reported an increase in the balance owed. I called - and spoke to a supervisor named - and was told they had not reported that to MDS and they were not authorized to report that. She told me she doesnt even know how they got that information. - shows the difference in the bill and medicaid 's payment and shows it under not patients responsibility. Also balance billing is prohibited by Federal Law for -. MDS was aware I had - and had coverage for this bill. She lied to try and get me to pay it, they increased the bill without - consent, reported info they knew to be incorrect, failed to report to the CRA 's this debt is disputed and have never sent any - or correspondence. They are also a " Business associate '' of -, and a MEDICAL debt collection agency and updated my credit report with an ILLEGAL balance bill that I am not responsible for after this debt was paid by insurance.
Medical Data Systems, Inc. customer in Georgia
Mar 30, 2017
* Source: CFPB Complaint Database
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