1. Dispute a paid medical collection directly with the CRA and they should delete.  If not deleted, but verified, send HIPAA letter (Whychat’s process – insert b)
2. Dispute valid but unpaid medical collections because you need the CRA to verify the balance.  There may be no valid balance due and the CRA will delete.  Only after the CRA has verified and you agree that the amount is correct is the HIPAA letter sent with payment (Whychat’s process – insert a).  The payment amount should be the same amount as was verified by the CRA and on your CR.
3. If the medical collection account is “not mine” or inaccurate, you need to have disputed the medical collection listing with the CRA.  Only after the CRA verifies and does not delete an invalid or inaccurate medical collection do you send the HIPAA letter (Whychat’s process – insert a or b).

start with # 2    read this  and then copy the letter…..you might need to call & get the address for the HIPAA COMPLIANCE OFFICE    it migh be the same as hospital but call to be sure.

PRE HIPAA MEDICAL DISPUTE LETTER TO CRA

You dispute medical accounts this way:

Dear CRA,

My name is xxxxx xxxxxx , my SS # is xxx xx xxxx.

I am sending this dispute certified mail # xxxx to make sure you receive it.

I have no knowledge or records of account # xxxxx on my report # xxxxx.

Please advise me as to the name and address of the medical provider, the date and type of service,and to whom the service was provided, as any account I might have had would be obsolete.

If you can obtain this information, I also would need the name of the person providing this data, and the manner in which it was provided in order that I may pursue additional legal remedies.Very truly yours,

xxxxxxMake sure you HAND ADDRESS the envelope, use personalized stationery and purple or teal font, ( preferably italic).

DO NOT send it RR -WAIT FOR THE FULL RESPONSE FROM THE CRA BEFORE CONTINUING WITH THE HIPAA LETTER PROCESS

FORM LETTER TO ORIGINAL HEALTH CARE PROVIDER

(Your Name)

(address)

(City,State, zip)

s.s.# (social security #)

HIPAA Compliance Office

( health care provider creditor)

(address)

(date)

Dear Sir/Madam;

This letter is in reference to (account #) for services provided to (name of patient) on (date of service).

In regard to the bill on this account in the amount of     $102.??:

 

Enclosed please find my remittance of  $ 102.??  for payment in full of this account.

  I would copy bill from ins. co & send it with payment.

Please be advised that under Federal Statutes. the Fair Credit Reporting Act, (15 U.S.C. § 1681 et seq)and (name of your State)’s Consumer Credit Statutes, you may be held liable for the actions of (collection agency name).

(a) Duty of furnishers of information to provide accurate information.

(1) Prohibition.

(A) Reporting information with actual knowledge of errors.

A person shall not furnish any information relating to a consumer to any consumer reporting agency if the person knows or consciously avoids knowing that the information is inaccurate.

In addition, the HIPAA and (name of your State)’s Medical Privacy Statutes are in effect in this situation even though the health care services you provided may have been prior to enactment .

The Privacy Rules prohibits a covered entity from using or disclosing an individual’s protected health information (“PHI”) unless specifically authorized by the individual or otherwise allowed under the Privacy Rules.

In general, PHI encompasses substantially all “individually identifiable health information” that is transmitted or maintained in any medium. “Individually identifiable health information” includes health information that is created or received by a health care provider, health plan, employer, or health care clearinghouse, and that relates to an individual’s physical or mental health or condition, including information related to an individual’s care or the PAYMENT for such care.

Your furnishing of my account information to (collection agency name), is not in compliance with HIPAA,or (name of your State}’s Privacy Act, and any subsequent reporting of this account on my credit reports to (credit reporting bureaus) is a clear violation of Public Law 104-191 (“HIPAA”) since there can be no permissible business purpose in divulging protected health information to anyone on an account once there is no longer any payment due.

You are required under the FCRA and FACTA to accurately report the status of any account to the credit bureaus, and you are prohibited under the HIPAA and State privacy regulations from doing so on a PAID account, as there is no longer any permitted business purpose.

Therefore I am requesting you promptly rescind all such account information furnished to (collection agency) and require them to purge their records of all reference to this account, and that you insure that any and all reporting of this account is immediately deleted from my credit reports.

This simple procedure to request the deletion of ALL reference to this account from the records of ( collection agency name) and to require them to have this account information deleted in its entirety from my credit reports will resolve this problem completely.

Please respond, in writing within 10 days that you are processing this request.

I am reserving the right, to take appropriate legal and civil action including reporting to any applicable regulatory authorities any lack of cooperation or compliance with this request.

I hereby waive my rights under HIPAA and any State Privacy Act for the single purpose of your transmission of this request and accompanying documentation in any required report you must make to your E &O insurance carrier.

Sincerely,

signature

(Your Name)

The hospital should pull the account from the CA……Wait to hear from them

IF you do not hear from the hospital and the cash the check  let me know!