Patient is dunned in billing mix-up

By NANCY PARADIS

© St. Petersburg Times, published May 3, 2000

I am writing to you to voice my extreme anger and frustration with the billing department of Spring Hill Regional Hospital. I gave birth to a baby girl in the hospital on Nov. 29. My first ultrasound was done on July 29, and the bills began to arrive in August. I contacted my insurance company and the hospital's billing department, as did my doctor's office. My insurance company had been incorrectly billed. The doctor's office gave the billing department the correct code and was told it would be rebilled.

As I was having a difficult pregnancy and have a history of miscarriages, a second ultrasound was done on Oct. 7. Those bills began to arrive in January. As before, an incorrect code had been used instead of the correct one that was on the referral. The hospital contacted me and told me that my doctor's office must contact its coding department so my account could be rebilled. The doctor's office called several times and left messages with its phone number, my name, both of my account numbers and the correct code.

On Feb. 3, I received another notice. I contacted both the hospital and the doctor's office and was told to ignore it. On Feb. 17, the saga continued, although this time I was told my accounts were being turned in to a collection agency. After six unsuccessful attempts, I finally reached the billing department on the seventh try and was told the situation would be taken care of. I assumed this would be the last I heard of this, as I finally got my explanation of benefits from my insurance company that the Oct. 7 ultrasound had been paid in full.

I was therefore shocked to be called and harassed at my place of employment on March 14 by the hospital's collection agency. The collection agent was verbally abusive, used foul language and told me he would harass me every day at work until I paid my bills.

The bottom line is that one account is paid in full, yet I am being turned over to collections. The other account has never been rebilled correctly despite several attempts by me and my doctor's office to resolve this. Please help me. Amber Harris

Response: Thomas Barb, executive director of Regional Healthcare in Brooksville, of which Spring Hill Regional Hospital is a part, apologized for the difficulty you encountered regarding your accounts. He said he has directed the collection agency to investigate and deal with the individual who apparently contacted you in such an unprofessional manner.

The hospital's investigation indicates that your insurance was billed promptly after each visit. However, both billings were rejected because the physician had indicated that the tests ordered were well-being services, which are not covered by your insurance. You were informed by the hospital that it could not rebill the insurance unless your physician provided a diagnosis. You contacted your physician and he provided a diagnosis for each visit, Barb said, but after a long delay. The hospital rebilled as soon as the diagnosis was received. Unfortunately, its computer system automatically sent the accounts to collections when the insurance rejection was received and no payment was received from you.

At present, one account has been paid in full. The diagnosis code on the other account was received March 19 and rebilled on March 20. Hospital staff confirmed that the insurance company received the rebill and was told that it would be processed within two weeks.

Barb said the collection agency has been instructed to cease all collection efforts and to ensure that no adverse credit reporting occurs on either of the accounts.

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