[djh602]

I checked my Credit Report recently and saw where two different collection agencies had placed two different Medical Accounts (which had been placed for collection) on my credit file. On both of these files I was not the patient only the guarantor of the debt (because it was my insurance that was used).

I contacted one of the companies who stated that they could not discuss the file with me because the patient (who is my wife) was considered an adult at the time of services. I was advised that it would be a HIPPA violation for them to discuss any Information about the doctor(s), and other health care providers, the billing information about either the doctor or clinic that preformed such services, or the dates said services were provided. I was told in order for them to be able to discuss this account with me that I would need written authorization from my wife giving the Collection Agency permission to discuss the account with me.

I contacted the second creditor who mailed me a statement of account which had the Clinic's name on it, the Doctors name as well as the dates the services were provided, my insurance company information, as well as my wife's account number from the clinic.

So my question is since the first agency would not give me the information I requested because of HIPPA following the law and did the second Agency Violate the HIPPA Law?

Or was the first Agency misinformed about the HIPPA Laws and the second Agency give me the information that I was legally entitled to?

[JudyKayTee]

What did your wife sign concerning the release of information at BOTH places?

(It's HIPAA, by the way, not HIPPA.)

[AK lawyer]

... On both of these files I was ... only the guarantor of the debt (because it was my insurance that was used).
...

You signed something, I'm guessing, to guarantee that the medical provider would be paid.

[JudyKayTee]

You signed something, I'm guessing, to guarantee that the medical provider would be paid.

Wife may have signed consent to release info to husband at one provider and not another or one provider may have consent and not the other.

I understand the question but the answer to this particular problem is a signed authorization from the wife.

[djh602]

AK Lawyer

I never signed anything in regards to this bill. My wife went to the clinic (I wasn't aware of the visit) and filled out paperwork listing my insurance and me as the guarantor.

JudyKay

According to my wife she never signed a release of information form which would allowing me to see her file or any part thereof. I am thinking that the first company was correct in their actions and the second one may have violated HIPAA in order to collect on the debt since it is on my credit. I know even my own insurance company won't release this type information to me.

Not sure if it make a difference I live in Texas. However both providers are located in Texas.

[JudyKayTee]

Now I'm confused - you refer to insurance. Was this private pay or insurance?

Your wife had to sign SOMETHING about privacy and HIPAA when she went to each Physician - it's a Federal requirement. She either signed to release info to you or she did not. It may be one of each.

If there WAS a HIPAA violation the most that happens is the company is warned. No one collects any money - and I know you didn't ask but everybody seems to think "they" can sue over this.

This really is a great question - sorry it happened to you but, again, great question!

[ScottGem]

In my opinion neither credit bureau was wrong. Nothing was released to you that indicated diagnosis or treatment. So I believe the credit bureau was within their rights to release what info they did since it was attached to your account. The other bureau was more likely trying to save themselves work and using HIPAA as an excuse. They were playing it safe.

But what I'm unclear about is why you are asking. You are clearly responsible for the debt so the status of these debts and their inclusion on your report shouldn't be in question.

Even if there was a HIPAA violation, what do you think that gets you?

[djh602]

ScottGem and JudyKay


I am not interested in collecting any money or suing anyone. I am not sure how this bill was created. My insurance company requires a copay when a covered individual when we see a Dr. The copay is all that we would owe and nothing more. I believe that what is happening here is that I was charged for amounts that are my insurance company considered over the reasonable and customary charges. My EOB's state that such amount are not the responsibility of the insured. My insurance company is having to go back into archives to find the original EOBs which will take some time. Honestly I could make up a statement like the one the CA sent me on any computer. The CA is refusing to send me further information about this debt (which is required under Texas Law). So I was hoping that if they did violate HIPAA then would have some leverage to get the documentation that I am entitled to. Their stance is that I owe the debt and that I need to pay it. Mine is I am not sure that the debt is even a valid debt. All I am attempting to do is figure out some way to get the CA to co-operate with me.

[ScottGem]

First, I think I misunderstood here. I thought you got the reports from the Credit Bureaus, not the Collection agencies. If this debt is being collected from you, then you have a right to the information about the debt. You may not be entitled to diagnosis and treatment info, without your wife's permission, but you are entitled to the amounts and dates.

Your stance should be that you cannot and will not pay anything towards this debt unless it is proven that you owe it.

[JudyKayTee]

I would like more info - sounds like medical insurance was involved, his wife listed him as the "responsible" party. Why didn't health carrier pay?

[Synnen]

I also find it unusual that there was not a bill from the doctor's office before the debt was sent to collections.

I get a bill EVERY time my insurance refuses to pay.

So why did it get to collections before there was a chance to dispute the debt?

[djh602]

JudyKay

That is where this whole issue comes from (in my opinion). I was listed by my wife as the responsible party because it was my insurance. The bill for this one office visit (according to the CA) was $628.00 my wife paid the copay of $20.00 and the insurance company paid $142.70 so there was a total of $162.70 paid for the office visit. I think what is happening now is that someone is trying to make me pay for the charges that were considered excessive or unreasonable (due to the insurance contracts with the clinic). The clinic refuses to give me any information saying only that I need to get the information from the CA. The CA sent me a statement which looks like it was printed on a random computer (Not a Professional style statement). The CA is saying that all they need to send me if validation of debt which is what they are saying I was sent. There is no explanation of charges vs payments and they will not send me any other documents that I requested. I have contacted my insurance company who stated that they would check to see if they could locate the EOBs from the date of service which was 2 years ago. My insurance company states that it might take some time for them to actually obtain the information. So I turned to the Clinic who immediately referred me to the CA. I discovered this debt while checking my credit report and until that time I am almost positive I never received any information about this debt. My wife says that she does not recall receiving anything either. So unless I can figure out a way to get the CA to co-operate this may take a while to clear up.

SYNNEN

Good question! I am wondering the same thing myself. That is why I think that there is a issue here.

[ScottGem]

So unless I can figure out a way to get the CA to co-operate this may take a while to clear up.

It's going to take a long time! Stand by your guns. Your are entitled to detailed copy of the services performed.