Consumer complaint received 2017-03-30
Product: Debt collection — Medical
Issue: False statements or representation — Attempted to collect wrong amount
Company: Medical Data Systems, Inc. (GA)

On XX/XX/2017 i called XXXX to check on the status of an insurance payment and was directed to call the collection agency for that information. I explained this is for a recent claim submission. The XXXX rep said I needed to speak with the collection agency and they have access to all of the same information XXXX does. I then contacted Medical Data Systems regarding a debt that was placed with them. They do not own this debt. I explained i was calling to verify the claim status of a retroactive insurance payment for this account. The representative informed me that the balance was now {$2800.00}. I stated, that was the original balance and the hospital adjusted the balance because of their contractual agreement with XXXX. She said well they denied the claim. I explained to her that the hospital billed XXXX and thats why it was denied and XXXX iis who needs to be billed. I explained to her I had just spoken with the hospital and the XXXX who is responsible for XXXX and XXXX said I needed to make sure the claim was submitted. The Med Data XXXX said it was submitted and they denied the claim. I asked her, XXXX or XXXX? She said XXXX denied it. I asked when was it denied because I had just spoken to them that morning. She told me XX/XX/XXXX She then said payment is due in full for {$2800.00}. I told her I have spoken with the department of community Health and they have informed me that I have coverage for this day and the claim needs to be submitted to them. The rep said insurance will not pay claims outside of 6 months. I said, again I have already spoken with XXXX ( the XXXX rep told me to inform XXXX and MDS they have 6 months from the Retro approval date to submit the claim ) and was informed the hospital has 6 months from XX/XX/XXXX to send this for payment. She said they already denied it. I called XXXX again and spoke with XXXX Ref # XXXX and she said that was not true and MDS needs to contact XXXX because they are trying to collect for XXXX and claim details can not be discussed with the consumer. I called MDS back & was told " we do n't do that '' I argued and she said you dont have proof you have coverage. I said Yes I do. ( I could hear the supervisor in the background saying '' is that that medicaid lady calling again '' She said fine, send your proof to my supervisor at XXXX. I sent proof. I called XXXX that evening and was informed the claim had not been submitted yet. They had just submitted it that evening. On XX/XX/XXXX I checked the claim and XXXX payed it so I checked my credit score, MDS reported an increase in the balance owed. I called XXXX and spoke to a supervisor named XXXX and was told they had not reported that to MDS and they were not authorized to report that. She told me she doesnt even know how they got that information. XXXX shows the difference in the bill and medicaid 's payment and shows it under not patients responsibility. Also balance billing is prohibited by Federal Law for XXXX. MDS was aware I had XXXX and had coverage for this bill. She lied to try and get me to pay it, they increased the bill without XXXX consent, reported info they knew to be incorrect, failed to report to the CRA 's this debt is disputed and have never sent any XXXX or correspondence. They are also a " Business associate '' of XXXX, and a MEDICAL debt collection agency and updated my credit report with an ILLEGAL balance bill that I am not responsible for after this debt was paid by insurance.