Consumer complaint received 2018-01-10
Product: Debt collection — Medical debt
Issue: False statements or representation — Attempted to collect wrong amount
Company: AR Resources, Inc. (PA)

I 'm a 13 year XXXX XXXX survivor. Within the last 13 years, I have been diagnosed with XXXX, and more recently XXXX. 

At my annual XXXX screening in XX/XX/XXXX with my XXXX ( XXXX XXXX XXXX ), I was prescribed a drug called XXXX for the treatment of my recently diagnosed XXXX. My insurance does not cover XXXX due to the fact that there is no generic version on the market ; we discussed finding another option. XXXX XXXX suggested the medical billing department ( for the sake of this letter medical billing department will be referenced as MBD ) look into assistance programs ; someone in the MBD would be in touch with me. 

I received a phone call from XXXX in the MBD in XX/XX/XXXX. Already having the knowledge that my insurance would not cover XXXX, I was signed up for something called a " {$25.00} XXXX  Assistance Program '' by a woman by the name of XXXX XXXX. XXXX told me the XXXX would cost me {$25.00}. I could n't believe it-I said to XXXX that this was so fantastic because I couldnt get XXXX otherwise. XXXX just signed me up ; I didnt have to do anything, sign anything great! I explained that if this program wasnt for real, or was anything other than the {$25.00}, I would not move forward with the XXXX because I could not afford it. I was assured by XXXX that my responsibility would be {$25.00} plus XXXX XXXX cost. 

I scheduled my XXXX for XX/XX/XXXX. The day of my appointment, I paid my {$25.00}, got the XXXX XXXX needed then proceeded to get my first XXXX XXXX. The next XXXX was scheduled for XX/XX/XXXX. 

In XX/XX/XXXX, I received a letter from XXXX XXXX XXXX ( the XXXX affiliate to my healthcare plan ) stating that my XXXX office was being denied reimbursement for the XXXX. I immediately called the billing department, and spoke with XXXX again. She received the same notice, assured me they were working on this matter, and my responsibility was still {$25.00}. 

About a month later, I received an invoice dated XX/XX/XXXX for the XXXX XXXX from the XX/XX/XXXX appointment in the amount of {$63.00}. I called and paid the {$63.00} on XX/XX/XXXX via credit card with a  woman named XXXX in the MBD. This invoice was itemized to include everything from the XX/XX/XXXX appointment, and stated Insurance {$1400.00}, and Patient {$0.00}. Please note : why was my insurance involved if we knew this drug was not covered? This was the purpose and the reason for the {$25.00} XXXX Assistance Program, was it not? 

At the end of XX/XX/XXXX I called my XXXX office to make sure everything was on schedule for the upcoming XX/XX/XXXX XXXX. I was told they were still experiencing problems with being reimbursed. I told them if I could help in any way I would. 

As a result of this discussion, I immediately cancelled my second XXXX XXXX scheduled for the end of XX/XX/XXXX. If the office was having a difficult time with the first XXXX, I wasnt about to make the situation worse by getting a second. Also, as a side note, I had my annual XXXX XXXX XXXX  appointment scheduled for XX/XX/XXXX with XXXX XXXX - I figured we could review other options at that time. 

On XX/XX/XXXX, I received another letter stating upon review that XXXX XXXX XXXX has deemed XXXX medically unnecessary. Again, Im thinking why is my insurance involved at all? I called the MBD and spoke with XXXX. I explained what was going on, and XXXX said she get back to me after review. XXXX called me back and explained the claim is first sent to my insurance, the insurance pays out whatever amount ( if anything ) then the balance goes to the assistance card ( aka the XXXX Assistance Program ). XXXX said the assistance card will pay out up to $ 3000/year. I thought to myself - great! that maximum pay-out figure will more than cover what the MBD needs. Finally, this is where the {$25.00} XXXX Assistance Program kicks in. I reiterated to XXXX that my only responsibility could be the only {$25.00} as I was originally told by XXXX last year. During the back and forth on XX/XX/XXXX, I was able to help XXXX and XXXX with some paperwork to help them get reimbursed. XXXX faxed me some paperwork to fill out ; I faxed it back to her the same day. Again, I wanted to help them get some compensation. 

On XX/XX/XXXX, both the billing department and I received a letter from XXXX ( XXXX manufacturer ) stating I didnt meet some criteria for reimbursement. Their reason was Our records indicate that you have insurance that covers the medication requested. It was stated from the beginning that my insurance would not pay/XXXX was not approved. So now both my insurance and the drug company are not paying anything to XXXX XXXX XXXX. Obviously this poses a huge problem-what XXXX signed me up for was not going to help ( XXXX was opting out after the fact ). 

In XX/XX/XXXX I received my first invoice for {$1100.00} from the billing office. This is the same office and 3 different people that on numerous occasions confirmed my responsibility was only {$25.00}. I called to explain there must be some mistake. I was then told, ( very meekly mind you ) that because MBD would not be reimbursed after several attempts that the cost had now become my responsibility. I told them that this can not be-I explained I would never have gotten the shot in the first place if it had n't been for the " {$25.00} XXXX Assistance Program. '' I told them I would NOT be able to pay this invoice and to do whatever necessary to remove the balance from my account. I was told the MBD would speak with the practice manager. 

Another month passed. Another invoice came. Another call made. 

Again, I made it very clear I would not be paying the invoice ; I was lied to on more than one occasion by several people. 

Also, ask yourselves this : XXXX mentioned the assistance card paying out up to $ 3000/year ; when does this card come into play? Why is the assistance program/card I was signed up for not kicking in to pay the balance? 

This is what I believe happened : - MBD signed me up for program - Received XXXX - MBD submitted a claim to my insurance even though XXXX had already been denied - MBD coded the claim to my insurance, {$280.00} was paid out from my insurance - Claim was then submitted to XXXX ( assistance program ) - XXXX denied claim due to my insurance paying out the {$280.00} ( the XXXX  XXXX cost ) - XXXX assistance program was how this XXXX was supposed to be paid for, so upon denial, now what? 
- Because the insurance was involved, XXXX opted out - Almost like the MBD was trying to get money from anywhere possible ; two unaffiliated entities or MBD never signed me up for the program at all In XX/XX/XXXX, and I received my very first collection agency notice for {$1100.00}. In my entire adult life, I have never paid a bill late let alone been in collections until now. As of today ( XX/XX/XXXX ) my FICO score is XXXX, and the fact that lies will potentially jeopardize the credit score I have worked my entire life to obtain/maintain infuriates me.