<p>H received a phone call at his office yesterday–from a “collection agency.”
He was told that the US government hired this collection agency to have “overpayments”
repaid. This is from H’s medical practice that was operating 2001-2003. The business has been closed since 2003. The caller claimed that they have been “trying to contact” H since 2006! The amount of overpayment was very small–about $15. However, with “fees and interest” they are now asking for $150! I know that this isn’t a big sum of $, and H is happy to return an overpayment. However, two things bother me about this: #1–I can’t believe that anyone trying to find H since 2006 has never heard of white pages or Google. (H is the only person with his name in the US in his profession. His first name is uncommon. Pages of stuff will pop up if you Google his name–all him. We don’t have unlisted numbers. H is SUPER easy to find.) #2: 1000% fees and interest? Really? Does H have to pay for 6 years of unbelievable incompetence in “trying to locate” him?
According to H, caller was polite, but tried to pressure him into “promising” to pay by Oct. 15, said he’d get a registered letter about it. I wondered if this could be a scam because anyone in his profession could feel threatened that they’d be turned in for medicare fraud and would be happy to pay a relatively small amount to make sure that didn’t happen. And if they were referring to a closed practice or an “overpayment” received many years ago–who is going to be able to look that up?
Any thoughts on this? What would you do? Argue or just pay the $150?</p>
<p>I would absolutely demand proof that this is a valid debt. $150 is not a small amount of money. Ask for the name of the agency the debt is owed to, and then call that agency for confirmation. If they won’t tell you, then it’s clearly a scam.</p>
<p>The money is supposedly owed to the US government - Medicare–due to an alleged $15 “overpayment” of a medical bill sometime between 2001-2003.</p>
<p>If it turns out you feel it is legit, I would pay with a bankor cashiers check so they don’t have your bank info.</p>
<p>Insist on itemized documentation with the patient name, type of service, dates, etc. That usually shuts these people up.</p>
<p>If it’s Medicare trying to collect an overpayment, they would be contacting you. Smells like a scam to me, but I’d make THEM prove their case before ever shelling out a penny.</p>
<p>There needs to be proof and documentation. I wouldn’t send some random phone caller money. If this is real, which is doubtful, it’s already gone 6 years and can manage to go more than another week or two to make sure it’s really all legit. I wouldn’t even trust just some letter - I’d want to get confirmation from the government that it’s really legit.</p>
<p>As far as the fees/interest, I can believe it. The fee itself must be considerable. No one would bother to try to collect if they were only going to make $5 or $15 on it. Actually, I’m surprised any legit collection agency would bother with a $15 debt even given a markup to $150. That’s not enough money to make it worthwhile IMO (but I’m not in the debt collection business).</p>
<p>I would ask for documentation. Who was the patient. What was the date of service. What was the procedure. What was the original amount. What was the reimbursed amount. Why are they claiming an overpayment.</p>
<p>What was the legal form of the medical practice? Company, LLC, partnership, sole proprietorship? Does your husband have liability despite the form of the company?</p>
<p>Check his credit report. Has the Government reported something on his credit report.</p>
<p>If you do pay, only agree to make it payable to the Federal Government. If they complain, then tell them they can take it up with the federal agency that hired them.</p>
<p>This smells bad to me. </p>
<p>Insist on proper documentation.</p>
<p>I would contact the Centers for Medicare and Medicaid Services - [Home</a> | Centers for Medicare & Medicaid Services](<a href=“http://www.cms.gov/]Home”>http://www.cms.gov/)</p>
<p>I’m sure there’s a billing/collections office that can confirm - directly from an agency employee - that there is a valid debt.</p>
<p>^ Agree that’s the group to contact.
Just for some perspective: [What</a> You Should Know About Medicare Audits](<a href=“http://www.aaos.org/news/aaosnow/feb12/advocacy3.asp]What”>http://www.aaos.org/news/aaosnow/feb12/advocacy3.asp)</p>
<p>I wouldn’t pay anything until sufficient documentation came, to ensure this isn’t some scammy piggback on a legit program.</p>
<p>It was an LLC, if that matters. Solo practice.
It is really ironic, considering how low Medicare reimbursement is for primary care. Any thought on the length of time
(10 years?) since this “overpayment” or the “inability to contact” H for 6 years?</p>
<p>My H got taken in by a scam (totally different premise than this) where the amount they alleged he owed was small, only $45. So he paid. The amount doesn’t have to be big to be a scam. It adds up nicely for them. This smells fishy to me.</p>
<p>^^ For a scam maybe people just go ahead and pay a small sum without many questions where they’d be less likely to if it was a much larger sum.</p>
<p>Several years back I rec’d a call telling me I had an outstanding balance due on something or other. It smelled fishy and I told the person on the other end I would “happily” pay the balance, but needed everything to be sent to me in the mail. They readily agreed, and I never heard another peep. That was the end of that.</p>
<p>I would have to agree, $150 here, there and everywhere adds up nicely.</p>
<p>I don’t take Medicare, but I usually get overpayment letters fairly quickly. I generally get one letter saying it happened, then one saying pay, how, and a quick deadline . Outside of Medicare at least, there are generally rules aout how much time can elapse before something like this happens. For example, if you don’t submit a claim within 90 days, you might not get reimbursed. </p>
<p>Does your husband still have medmal? Maybe his carrier or local med association (AMA-they ought to be good for SOMETHING on a doctors behalf!) can help. Or someone local who does medical billing. There may be info available online. In any case, don’t send money without details on paper, or you may not even get credit.</p>
<p>BTW, I keep my records 10 years; longer for kids, so there may be an expectation that there is a way to see if it makes sense.</p>
<p>Isn’t there a statute of limitations for collecting an overpayment? 9 years seems to be a long time. Plus, shouldn’t you have received a formal letter from Medicare?</p>
<p>Apparently recently increased from 4 to 10 years with the Affordable Care Act! But you get 60 days once you “know”.</p>
<p><a href=“http://www.wnj.com/Publications/Medicare’s-60-Day-Overpayment-Rule-Uncorrected-Mis[/url]”>http://www.wnj.com/Publications/Medicare’s-60-Day-Overpayment-Rule-Uncorrected-Mis</a></p>
<p>On another forum, a doctor was asked to repay $50k to a commercial carrier, after they audited five years worth of charts, and decided they couldn’t substantiate the coding.</p>
<p>[CMS</a> Issues Proposed Rule on Overpayments to Medicare Providers and Suppliers | Skadden](<a href=“http://www.skadden.com/insights/cms-issues-proposed-rule-overpayments-medicare-providers-and-suppliers]CMS”>http://www.skadden.com/insights/cms-issues-proposed-rule-overpayments-medicare-providers-and-suppliers)</p>
<p>" Under the proposed rule, a new 10-year lookback period would apparently apply to overpayments resulting from even routine error. Providers and suppliers presumably would be expected to apply this expanded time period in conducting a “reasonable inquiry” regarding a potential overpayment and would have to consider whether to apply this time period in conducting internal audits."</p>
<p>Seems to me that if your DH routinely receives payments from Medicare, then Medicare knows where to reach him in the case of overpayment – which, as others have said, certainly happens from time to time. This smells like a scam to me from the get-go.</p>
<p>Thanks for the links–I’m learning. . .
I thought that medical records from adult patients should be kept for 7 years.<br>
It has been 9 1/2 years. I can’t even remember where the records are/were. (I believe they were turned over to another doctor in the area when H closed the practice. Business/financial records are another matter. H hasn’t given a thought to this practice in years.)
We have moved since then, but in 2006, H was practicing in the same state. He has taken medicare/medicaid patients continuously, so they have known his location at all times. But apparently the government has contracted with auditors/collection agencies and turned this work over to them. It used to be 3 years that they could go back and audit, but now it is 10? Maybe that’s why they contacted him now. (H has a squeaky clean record, nothing to fear–and has never heard of anything like this before.)</p>
<p>H asked for patient’s name, date of service, etc.–the caller said she didn’t have that information. He asked how they had attempted to contact him–caller said multiple letters were sent to an address–the address of a collection agency that was collecting H’s payments since that practice closed! That agency has our address–we have received mail from them from 2003 until this year. I suppose there would be no record of that agency returning mail to the other collection agency? How/why, after 6 or more years, did someone finally, now, decide to Google H? I always thought collection agencies were supposed to be good at tracking down people. . .</p>
<p>Sorry for the rant. This kind of thing really IRKS me (I get disproportionately annoyed when I perceive injustice–especially if it has to do with tangled bureaucracies, incompetence)-- They spent 6 YEARS sending letters to the same address (another collection agency)–that kept getting returned? I can’t believe it. After one returned letter, don’t you think they’d try to find another address for the person? I’d gladly donate $150 to charity–but can’t stand the idea of funding this type of inefficiency.</p>