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    jcapulet50's Avatar
    jcapulet50 Posts: 3, Reputation: 1
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    #1

    Jun 10, 2007, 12:28 PM
    Summons for medical bill collection
    Thank you in advance for any help offered. Here is the situation. A medical bill has been put in collections from a group of NICU doctors that were out of network (insurance). The insurance company worked out a deal with the doctors based on some in network prices. I am being billed for the rest. We disputed this with the insurance company and were denied. Original services were done in 2004. We then started going through some other surgeries and medical issues with our child and put off the bill. Now we have received a civil summons demanding almost $7000.00. I'm down to 5 days left to answer the summons. I believe the SOL for me to go back against the insurance company has passed because of a clause in the policy limiting that to 2 years. In the state of FL it is 5 years unless stated otherwise. We have several bills in collections and have made efforts to pay off what we can. The summons is for breach of contract. They are asking for a judgment for the $7000.00 bill + attorney's fees + interest from 2004 + any other further relief the court deems proper. They accuse the we will be unjustly enriched if we were not required to pay. So far they have received something like 92k of the 99k they billed to insurance.

    I have called the collection attorney to see about getting a discount before answering the summons. They said it was to late and that the discount they offered in 2004 was only good for 30 days.

    Questions I am stressing about: 1. It an answer as simple as admit/deny to each line in the summons or should more information be included.

    2. In FL I believe that mediation in mandatory before a court date is set. Is there any chance that in mediation the bill may be reduced? We have a lot of equity in our home but don't have a lot of extra income and still have many medical issues with our child.

    3. Are there any reasons the collection company would want to work out a deal are can they just smell "blood" because of the equity in my house.

    4. Is there any way to estimate the court/attorney cost that may be added to the judgment if/when this goes to mediation or trial. Right now they want $700 for their fees.

    5. Is this bill going to turn into @15000.00 + by putting up some fight.

    6. We don't dispute the services, just that our insurance company should have paid and feel they should have went after them.

    7. Can they get a judgment for interest from the date of service? How horrible can that turn out to be.

    8. Can I get an attorney involved after I answer the summons without one.
    Fr_Chuck's Avatar
    Fr_Chuck Posts: 81,301, Reputation: 7692
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    #2

    Jun 10, 2007, 01:07 PM
    First if you are personaly liable for any money due from hosptials and doctors over what insurance pays. If you go to out of network doctors and hospitals many policies pays 50 percent of the total bill or less after any deductables that should apply.

    You should have been working this out 2 years ago, not waiting for now, debts do not go away.

    If you disputed the debt to the insurance, what did you expect them to pay?

    There is a change the bill may be reduced if you can do a cash offer, but if you are talking making payments most likely not.

    They don't want the equity in your house, they will want a garnishment of your paycheck, or an attachment of your bank accounts. They could care less for a lien on your home where they have to wait till it is sold to get their money. ( but they will take it, if they can't get anything else)

    The bill will keep gaining interest and as lawyers and court fees are added, it will keep getting larger.

    I am sorry, the insurance company only pays exactly according to their contract. If anyone ever goes to a hosptial or doctor that is out of group, they are going to have to pay a much larger amount, that is written into every policy. So get your policy out, what it says they will pay is all they will apy.

    I will assume they have already been adding interest, most do.

    If you can afford the several thousand for an attorney, you may as well just use that and pay on the bill. ( personal opinion) but you always have the right to get an attorney involved.
    jcapulet50's Avatar
    jcapulet50 Posts: 3, Reputation: 1
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    #3

    Jun 10, 2007, 01:29 PM
    There is a clause in our insurance to if no other doctors in network are available then in network levels will be honored. $2000 max out of pocket and 80/20 split before that. They did the 80/20 but are charging over 2000 ( at least that is how I understand it)
    We did dispute this even going to Florida insurance regulators but then more surgeries came, more therapy, hurricanes and we could only keep up with so much. No doubt I should have kept better track, we have no interest in not paying our medical debts. I offered them a 1 time payment last week (from equity loan) in exchange for a discount and they refused. Not including medical bills we have little over 200 week for food, gas personal items would this be taken into consideration in mediation? The real thing I'm guess I'm trying to figure out is it worth trying to argue for sympathy ( a lot of people are a lot worse off) or just pay and hope its over with. I'm afraid if I pay there will still be surprise fees to pay. I feel the doctors who new of the insurance clause could have fought harder for it. There was no choice- this hospital and its doctors had to be used.
    Fr_Chuck's Avatar
    Fr_Chuck Posts: 81,301, Reputation: 7692
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    #4

    Jun 10, 2007, 01:50 PM
    Sympathy is worth a lot in church, and at the beach, but in court it is not worth a cup of coffee.

    No, doctors can care less for your clauses, and normally don't even know or care till their offices start the billing.

    For example, our local hospitals all have ER doctors who are not in any network, period, there is no other choice in local hospitals.
    So they do not accept what the insurance pays, and you end up owing them 100's for a ER visit becauswe that is all the insurance pays

    So don't expect them to care about anything except how much money they can get.
    jcapulet50's Avatar
    jcapulet50 Posts: 3, Reputation: 1
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    #5

    Jun 10, 2007, 02:22 PM
    So it sounds like it would just be best to just pay them in full this week then include that deal in my answer to their summons. Should I have to pay their legal fee? Do I ultimately even have a choice? Would this stop the court procedure or could they still look for interest or other charges to tack on?
    mr.yet's Avatar
    mr.yet Posts: 1,725, Reputation: 176
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    #6

    Jun 11, 2007, 03:59 AM
    SInce you have a summons, either adit or deny, you don't have enough information to reply.

    Has the attorney verrify the debt? If not have them do so by discovery.

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