Consumer complaint received 2022-03-08
Company: Transfinancial Companies, Inc
State: LA
Product: Debt collection
Sub-product: Medical debt
Issue: Written notification about debt
Sub-issue: Didn't receive notice of right to dispute

Complaint:
XX/XX/XXXX I went to XXXX XXXXXXXX due to XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX. Which I thought was XXXX XXXX  after being around someone who had it. During the hospital visit I teste Positive for XXXX XX/XX/XXXX. ( at XXXX XXXX XXXX XXXX ) I gave both insurance cards XXXX, and my health insurance from my employer during the time. I found out months later ( XX/XX/XXXX XXXX XXXX XXXX  ONLY billed my employers health insurance and not XXXX. After finding out and speaking to a representative at XXXX they refused to bill XXXX saying if it was known then they wouldve billed them and it was past filing time. I found that XXXX XXXX covered XXXX XXXX ( co insurance, & deductibles during the XXXX time frame ) I called XXXX XXXX and had them to reprocess the claim so I would not owe XXXX XXXX XXXX XXXX  the reprocessed the claim and submitted additional money to them ( per the agent with XXXX XXXX on XX/XX/XXXX ). On XX/XX/XXXX I received a notification indicating my XXXX score was changed and that a collection was placed on my credit report. I first googled the creditor they indicated I owed. It brought me to XXXX XXXX medical center. I contacted the insurance company who provided me insurance during the time which against was XXXX ( XXXX XXXX ) I spoke with them in reference to what XXXX indicated I owed on ( XX/XX/XXXX ) they indicated they was looking into it. XXXX stated they had statements indicating I owed {$200.00} only because I wasnt just billed for XXXX  but I had codes in reference to XXXX, XXXX, XXXX  etc. ( Things that my primary care provider treats me for but XXXX asked about during my emergency room visit for XXXX  to see if I have any other medical history and had treatment I was receiving elsewhere. ) XXXX removed the extra {$100.00} and processed the claim lower than usual to help additional due to the XXXX charges but couldnt process further XXXX would need to submit the corrected claim since I wasnt seen for anything else besides XXXX. After speaking with XXXX XXXX claims representative about the situation they gave me the option to contact the insurance fraud department, against XXXX ( because I was not being treated, for XXXX or nothing else BESIDES XXXX, they didnt diagnose me with anything Still wasnt sure why the Representative at XXXX XXXX XXXX stated they had XXXX  codes stating other treatment was done. So thats why the {$200.00} portion could not go away because other codes besides XXXX  was listed as why I was there, which was false after the 1 hour call with UHC I called Transfinacial to see where the amount of {$610.00} and to see who XXXX XXXX XXXX XXXX XXXX are since XXXX was given me a different amount. 
I spoke to a representative by the name of XXXX. XXXX indicated they received information from a business account and was limited on what they could see and say XXXX indicated she didnt have ANY information but the small amount of information that was supplied to the business account. I asked XXXX how is that I never received any information from them or Transfinancial saying this was owed as a collection, XXXX stated You should have received an explanation of benefits from my insurance company explanation my portion owed and this is what I owed after processing my insurance. I asked for the number and information to who it is I need to call and she stated shes not sure they only have information from a business account. REPEATEDLY. Then I asked should I call XXXX XXXX medical and is it from them? XXXX Stated Call XXXX I ask again is it from them she indicated their physcians bill separately and that is who XXXX XXXX XXXX XXXX XXXX is.In then proceed to inform XXXX I did call XXXX and they dont see a {$600.00} Bill . They are not able to see much I asked who is the provider XXXX indicated XXXX XXXX from an emergency room visit I informed XXXX Ive never seen a XXXX XXXX a day in my life XXXX, and the XXXX XXXX XXXX XXXX groups have been paid if theyve billed my insurance she indicated well maybe he was out of network. 
I Contacted XXXX XXXX and asked to speak to someone in billing to see why they havent paid the provider. I have a recording on my phone as well as XXXX has a recording indicating the EOB you received was correct the provider was out of Network WE PROCESSED THE CLAIM AS IF THE PROVIDER WAS IN NETWORK DUE TO HIM BILLING STATING THE CARE WAS AN EMERGENCY, WE PAID HIM ACCORDING TO WHAT WE WOULD HAVE PAID OUR OTHER PROVIDERS THAT ARE IN NETWORK. YOU WOULD HAVE OWED A CO INSURANCE AFTER PROCESSING THE CLAIM FOR IN NEWTWORK. / PROCSSING FRO OUT OF NETWORK YOU WOULDNT AND WE WOULDVE COVERED THE CLAIM 1ST I explained the PROVIDER NEVER entered my room I had a nurse come in and an assistant, with a Practitioner. Who indicated they needed to swab 2nd if he BILLED my insurance company stating I owe {$710.00}. They paid him for {$130.00}. He accepted the payment but still feel he is owed by me for NOT EVEN SEEING ME FOR XXXX  XXXX and pursuing me after accepting payment from my insurance company who billed him as an in network provider. I dont understand why he / billing company is trying to pursue insurance FRUAD so hard but obviously an attorney needs to be retained for fraud and damaging my reputation. 
3rd- how am I not allowed to get a letter from the collector to dispute the debt, but they are allowed to put this damaging information on my credit file, then tell me I shouldve recd documentation from my insurance company 9 WHICH MY INSURANCE COMPANY IS SAYING A WAY LESSOR AMOUNT THAN {$600.00} AFTER contacting Innovative healthcare by email I recd a secured message back from the rep saying someone would be in contact immediately from billing but after day # 2. Ive failed to hear a response again while this is riding my credit REPORT and damaging my rep. If the provider did not provide care and my insurance company paid the requested amount why are you trying to pursue fraud. 

I have filed a FTC report for this fraud information, I will also present this along with recording of all representative to an attorney to pursue for damages caused. I will also submit this to the insurance fraud department, the attorney generals office and more REMOVE THIS FROM MY FILE IMMEDIATLEY NO ONE HAS CONTACTED ME! PER THIS EMAIL ALSO I DO NOT AND I did not sign a HIPPA FORM RELEASING ANY OF MY INFORMATION TO TRANSFINANCIAL, Also AGAIN : All calls between me, XXXX XXXX, trans financial , XXXX XXXX, the newest billing company for XXXX XXXX XXXX, and XXXX XXXX I have recorder and will present to an attorney, I have also filed a fraud report against trans financial XXXX XXXX XXXX, and XXXX XXXX. I spoke to XXXX after speaking to numerous amounts of people in which the representative informed me she will send a request up to someone and allow time for them to review why other codes were billed and I wasnt seen for those issues. XXXX also informed me they never received the additional payment from my insurance provider for the service date and an E- Payment code of : XXXX was provided dated XX/XX/XXXX Please see ALL ATTACHED EOBs billed to my healthcare provider, if this is a SCAM to get additional money after already not billing BOTH insurance companies please stop. 

How will Transfincial STATE I OWE but tell me I should have gotten an EOB from my insurance provider not a LETTER IN THE MAIL FROM THEM. AGAIN PLEASE REMOVE THIS INFORMATION FROM MY CREDIT FILE. I will also forward this to the attorney generals office to the harm of my character, and credit. This ongoing battle is getting ridiculous & wasting my time if a lawsuit is needed against all parties I will be more than happy to file due to damaging my reputation, due to fraudulent activities again please CEASE ALL COLLECTING ATTEMPTS AND REMOVE UNTIL A ITEMIZED BILL YOU DID NOT GIVE ME TIME NOR NOTIFY ME TO DISPUTE THIS DEBT! PER THE AGENT I SHOULD HAVE WENT BASED OFF THE EOB ATTACHED TO THIS LETTER AND I DID. The collector has been forwarded to me. And in contact with me ESPECIALLY if you have no idea of who is collecting, and what they are collecting for. 

Also the amount billed minus the amount charged is also not adding up like he wants money for not even seeing me I have reported this information to insurance fraud department with the health care company as well.

Company response to consumer: Closed with explanation