Consumer complaint received 2020-12-30
Company: TRANSWORLD SYSTEMS INC
State: CO
Product: Debt collection
Sub-product: Medical debt
Issue: Written notification about debt
Sub-issue: Didn't receive enough information to verify debt

Complaint:
To the XXXX member Appeal : XXXX  of my kids have XXXX and have been receiving services at the center for XXXX and related disorders. 
XXXX XXXX XX/XX/XXXX started services at XXXX about 5 years ago. I always had many issues with their billing department such as : double billing for services, no-shows that never happened and was always very difficult to get ahold of anybody. I had to talk to multiple people to get things resolved and even then it would take months to get done. 
On XXXX XXXX got billed her deductible twice, after talking to about 6 different people on multiple occasions, a lady by the name of XXXX was able to clear it all out so I had a balance of XXXX . 
XXXX never got charged a co-pay for those services since they were using a code that did not require it. XXXX XXXX ( XX/XX/XXXX ) started services at XXXX about a year ago and was also not charged for co-pays. The billing code used previously was XXXX. 
I received a bill for XXXX  kids charging me ONLY the deductive at the beginning of this year and there were no other charges reflected on this bill. I send my payment in for both thinking I had a XXXX $ balance for both accounts, after the deductibles were paid. 
XXXX was recently discharged since she is doing very well so I got a goodbye letter with a XXXX dllr balance on it, which I was not aware of. I called about three times and left a voicemail to find out what this amount was for. I finally got a call back last week letting me know that XXXX has a balance since XXXX for her deductible. I told the person I talked to that XXXX had a XXXX $ balance for XXXX and that I did not know what the XXXX dllrs were for. He explain to me that the recent payment went towards the XXXX balance and the rest is for the copays for XXXX. This was the first time I had ever heard anything about a copay. I explain to him that I do not get billed for co-pay and have not for 5 years. He encouraged me to call my insurance company as my coverage had changed. I told him that I had reviewed the coverage and the coverage had not changed, which was then later confirmed by anthem. I then asked if XXXX had a balance, which he currently has a balance over XXXX!!! 
Since the person I talked to did not know any of the details of the balance and did not know " how to look, '' I asked to have a call back from a manager or a supervisor, which never called me back. I have left three voicemails with XXXX XXXX ( XXXX ) XXXX XXXX XXXX. XXXX but have not received a call back. I have also called and left voicemails on their main line but nobody has called me back as of XX/XX/XXXX. On XX/XX/XXXX I called XXXX and we both tried to call them to get ahold of them but were not able to talk to anybody ; they never called XXXX back either. 
Until this date XX/XX/XXXX, I have not received a bill from XXXX other than the one where they billed both XXXX and XXXX for their deductibles. I was not aware that, all the sudden, they were getting charged a copay. I called XXXX  and did further investigation and they explained to me that for some reason, now they are using a different code to bill us. The new code being used is XXXX along others. 
I am always up to date with my bills and have a credit score of XXXX, so as you can imagine the above details have brought a lot of stress to our family. I would like to appeal the co-pays up until the date I found out which is XX/XX/XXXX. I am also aware that I am responsible for the deductibles which I will pay for once the other balance has been resolved. I firmly believe that this was unethical billing since I was not made aware of this change and have not received any notification from the facility. I have made several attempts to reach out to them but have not been successful. The one time I did talk to someone, he was not able to give me details about the amount. 

Please let me know if you have any questions at XXXX or at XXXX XXXX XXXX XXXX. 

Received a call from XXXX for the first time since XXXX and I started tried to get ahold of XXXX  billing. Let a message to call him back. I called back and left a voicemail reminding him that last conversation we had where he was not able to answer any of my questions, so he was going to have his manager call me back. 
Since I disputed the balance with XXXX, I did not hear from them again until XX/XX/XXXX. I have called them multiple times and left multiple voicemails, with no successful discussions. 
I have left 6 voicemails since then. Only one person called me back on XX/XX/XXXX by the name of XXXX. She said that she will investigate and call me back but never did. 
XXXX Wed, XX/XX/XXXX XXXX XXXX  XXXX ( XXXX ) To : you ( Bcc ) + 1 more Details Hello XXXX, I have not received a reply from you on the XX/XX/XXXX email. Please respond to my email. 

Thanks, XXXX. 

-- -- -Original Message -- -- - From : XXXX XXXX To : XXXX XXXX Sent : Mon, XX/XX/XXXX XXXX XXXX  Subject : Re : XXXX  Hello XXXX, I reached out XXXX my insurance and they sent me a letter where they state that it was XXXX responsibility to keep me informed of our balance. They advice me to appeal the balance for the copay 's accrued since XX/XX/XXXX of this year. Can you tell me the process to appeal? 

Thanks, XXXX. 

-- -- -Original Message -- -- - From : XXXX XXXX To : XXXX XXXX Sent : Fri, XX/XX/XXXX XXXX XXXX  Subject : Re : XXXX  Hello, If I had known that I was going to start paying a co-pay in XXXX, I would have switch to " XXXX buy in '' because we can not afford to pay XXXX dllrs copays three times a week. 
Therefore, I am disputing the whole balance up until I found out we had a balance in XXXX. Can you please tell me the process to dispute a balance? 

XXXX. 


From : XXXX XXXX Sent : Thursday, XX/XX/XXXX XXXX XXXX  To : XXXX XXXX XXXX XXXX Subject : RE : XXXX  Hello, XXXX  XXXX XXXX and many all other insurances changed from T codes to 9 series codes effective XX/XX/XXXX. This was a requirement and a long process in the XXXX insurance industry. 

Again, I am asking what you are asking for in regards to your balance. 

Thank you, XXXX XXXX XXXX Collections Lead XXXX x XXXX From : XXXX XXXX [ XXXX : XXXX ] Sent : Thursday, XX/XX/XXXX XXXX XXXX  To : XXXX XXXX XXXX Subject : Re : XXXX I called my insurance and they said that they dont just decide to start charging copays for services. XXXX  started billing with a different code that came with a copay. The code used to start with a T now it starts with a 9. Per their manager it was XXXX  responsibility to notify us that we would start paying a copay. Which did not happen. What is even worse, we never got a statement. 

XXXX Sent from my XXXX On XX/XX/XXXX, at XXXX XXXX, XXXX XXXX XXXX wrote : Who do i need to talk to to dispute the charges? It is me Why am I now being billed a co-pay when I didn't for 5 years? Your insurance company determines your copays. Prior to XXXX, they did not indicate there was any patient responsibility. I can not answer the question of why they have now decided to apply copays to your policy, as it is their decision. 

Why did I not receive a statement? I have no explanation as to why you did not receive your statement as it was handled by a person no longer with XXXX. 

Why was I not made aware of the co-pays? It is not customary that we inform policy holders of changes to their policy. 

Below is what I found when I checked your benefits with your insurance. I can not waive the outstanding balance. I am offering to work with you on the balance. If you have a discount in mind please provide that information to me. I am also offering a payment arrangement as copays have accrued since your call XX/XX/XXXX. 
XXXX XXXX From : XXXX [ XXXX : XXXX ] Sent : Wednesday, XX/XX/XXXX XXXX XXXX To : XXXX XXXX XXXX Subject : Re : XXXX The payment in XXXX was only for the deductible and the statement only had the deductible in it. No other charges. I am aware that XXXX was handling this account since she had to fix it multiple times. 
Who do i need to talk to to dispute the charges? I would like to talk to a manager to figure out what happened and what can be done about it. I have not received any concrete answers as to : Why am I now being billed a co-pay when I didn't for 5 years? Why did I not receive a statement? Why was I not made aware of the co-pays? What is the process to dispute these charges? 

I am aware that this is not your fault but I need someone to fix this problem. 
I called my insurance and they said that there were no changes in my insurance so it is not my responsibility to know about this changes.

Please have your manager reply to this email answering all the questions above. 

Thanks, XXXX. 


From : XXXX XXXX Sent : Wednesday, XX/XX/XXXX XXXX XXXX  To : 'XXXX  ' XXXX Subject : RE : XXXX Your account was being handled by XXXX XXXX prior to it being handled by XXXX XXXX. 

Since XXXX is no long with the company I can not speculate as to when you were last billed. But I do know she had been in contact with you. 

We received a payment from you in XXXX and this would only happen if you were made aware of their being copays on the account. 


Sent : Wednesday, XX/XX/XXXX XXXX XXXX  To : XXXX XXXX XXXX Subject : Re : XXXX Hello, You responded to one question but there were three. Can you tell me why were were not notified that we were going to start getting charged a co-pay? Why did your company not send us a statement until I requested one? 

From : XXXX XXXX Sent : Wednesday, XX/XX/XXXX XXXX XXXX   Subject : RE : XXXX Hello, I responded to your email from earlier today and am responding to this email. I will contact your insurance about the deductibles as we did not receive any additional information after their first decision. 

XXXX From : XXXX [ XXXX : XXXX ] Sent : Wednesday, XX/XX/XXXX XXXX XXXX  To : XXXX XXXX XXXX Subject : Re : XXXX Hello XXXX, I tried calling you today but again the call was terminated multiple times. I sent you an e-mail asking you some questions but you have not replied. 
Can you tell me why were were not notified that we were going to start getting charged a co-pay? Why did your company not send us a statement for 8 months? 
Also, deductibles have already been paid for XXXX and XXXX for XXXX and XXXX so they need to be credited back to our account ; For both years. I called the insurance and that is what they reported. It was not the payment made to XXXX. 


XXXX. 
-- -- -Original Message -- -- - From : XXXX XXXX XXXX To : XXXX XXXX XXXX Cc : XXXX XXXX ; XXXX XXXX XXXX Sent : Wed, XX/XX/XXXX XXXX XXXX  Subject : Re : XXXX Good morning XXXX, I still have not heard from you. I emailed you back twice. Please reply to my emails. I still have not received a statement from XXXX  XXXX of my kids. 

XXXX Sent from my XXXX On XX/XX/XXXX, at XXXX XXXX, XXXX XXXX XXXX wrote : Hello, Just following up as to what I can reference when I call your insurance. Please let me know the information they need to relay to me. 

Thank you, XXXX XXXX XXXX Collections Lead XXXX x XXXX XXXX From : XXXX XXXX Sent : Friday, XX/XX/XXXX XXXX XXXX Subject : XXXX  Hello, Sorry about the phone tag issue. Just wanted to send out an email to confirm what I know at this point. 

I have not received an email from you. I located your email address from XXXX email. 

Phone issue I have reported this issue to our IT and they have our contracted phone company auditing our calls as I have been experience many issues since switching to our new system. 

Calls from XXXX XXXX I went back to all of my voicemails for the past two weeks and have not received a voicemail related to your claims. 
If you could tell me what information they were calling for, I can gather that and call their claims department. And if you have the info of the person you were working with I can use as reference. 

I have audited the account and determined that we are invoicing based on the insurances EOBs, but if there is additional info please let me know. 

Thank you, XXXX XXXX XXXX Collections Lead XXXX x XXXX XXXX The above are reference emails from the lead I talked to.

Company response to consumer: Closed with explanation