Consumer complaint received 2026-03-31 00:00:00
Product: Debt collection — Medical debt
Issue: Attempts to collect debt not owed — Debt is not yours
Company: Capio Partners, LLC
State: TX

Complaint narrative:
I am filing this complaint regarding inaccurate medical debt reporting and improper collection activity by XXXX XXXX involving services that were fully covered by my federal health insurance, XXXX. At the time the XXXX XXXX were rendered, I was fully insured through XXXX. Due to well documented administrative delays common with VA and XXXX processing, my insurance coverage was later retroactively backdated to include the applicable dates of service. This coverage and the required billing procedures are confirmed by Explanation of Benefits documentation. The original medical provider, XXXX XXXX XXXX, was notified multiple times that coverage had been backdated and that the claims needed to be properly billed or rebilled to XXXX. The insurance provider also directly notified the medical provider of what was required to complete proper adjudication. Despite these notices, the provider failed to properly resolve the claims through insurance and instead allowed the alleged balance to be placed into collections. XXXX XXXX is now reporting a collection account for approximately {$1500.00} on my credit report tied to XXXX XXXX XXXX. The account appears to have been opened or reported around XX/XX/XXXX and continues to update monthly, with the most recent update reflected in XX/XX/XXXX. The balance being reported is not accurate because insurance coverage applied to these services and the medical provider failed to comply with billing requirements after repeated notice from both myself and the insurance provider. To date, I have not received proper documentation showing that the provider exhausted all required XXXX billing procedures before referring this account to collections. Further, I have never received any meaningful written validation notice, complete billing history, itemized statement, insurance adjustment breakdown, or proof that XXXX XXXX has lawful authority to collect or report this alleged debt. Despite this, XXXX XXXX continues furnishing the account to consumer reporting agencies as though the amount is accurate, final, and legally owed. Reporting medical collections under these circumstances is inaccurate and misleading. Furnishing a medical collection account before proper insurance adjudication is complete materially misrepresents my alleged financial liability and violates the furnisher accuracy requirements of the Fair Credit Reporting Act, including 15 U.S.C. 1681s-2 ( a ) ( 1 ) ( A ). This conduct also constitutes unfair and deceptive collection activity where a collector continues reporting an unverified medical debt that should have been submitted to insurance coverage first. XXXX XXXX has continued reporting this account without ensuring proper insurance resolution and without verifying the legitimacy or accuracy of the amount being furnished. This is not a billing dispute and is not a request for payment arrangements or validation. This complaint concerns inaccurate medical debt reporting, failure to properly bill insurance, lack of lawful collection authority, and continued reporting of unadjudicated medical debt after notice. Credit reporting agency disputes and identity corrections are being handled separately. Nothing in this complaint should be construed as an acknowledgment of liability or a waiver of any rights under federal or state law.

Company response to consumer: Closed with non-monetary relief