<p>Atomom, that’s why it sounds like a scam. I guarantee you that no one spent six years sending your DH letters of any sort. It’s not inefficiency; it’s criminal.</p>
<p>^^ Right - sending 6 years of letters in the hope of receiving $135 for the effort to recover $15. It doesn’t make sense.</p>
<p>Whenever I get a call about a financial matter, even a charity solicitation, I tell the caller to contact me about the issue by mail – that I need something in writing in order to respond.</p>
<p>I appreciate your reluctance to give positive reinforcement to a dubious, or at least highly inefficient, process.</p>
<p>For what it’s worth, I hear that there are private agencies being allowed to go through the books of Medicare and Medicaid providers, for the purpose of discovering fraudulent billing practices and overpayments. If the outside agency finds an inconsistency, they are allowed to collect, and split the proceeds with Medicare/Medicaid. There is no downside for Medicare: they get some overpayments reimbursed. The downside for providers is that these outside agencies can decide on a whim that a billing was wrong or a bill was overpaid. This is creating a headache for providers.</p>
<p>I agree with previous posters who would demand documentation, including documentation of efforts to contact you. Even if a $15 repayment is owed, the fines sound very “iffy”.</p>
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<p>The relevant time period is 2006. How far back did they try to go? If 2003, then that is 3 years, if 2001, then it is 5 years. Once they established a discrepancy (2006), then they can keep the “debt” alive based upon different rules (attempting to collect on the debt at least once every 2 years, etc.)</p>
<p>As an LLC, the overpayment is an obligation of the LLC. If the LLC has been closed, then good luck on collecting from the LLC. Unless, there is some medicare rule that makes the doctor personally liable.</p>
<p>ODad, that’s what’s not clear to me- if they discover a discrepancy, they can go back x years further. But, how far can they go back just in checking or auditing, without some trigger? Is 2006 too far back or is it within the time frame from when they started researching? Confusing.</p>
<p>It’s still possible they discovered this a few years ago and sat on it, for any number of reasons- it may have been id’d by Medcare and not transferred to the coll agy. I wouldn’t presume they were actively seeking you. Maybe they went after bigger numbers first. Who knows.</p>
<p>I was tagged for a college loan about 20 years later (and the college has always known my current address.) The agy would not supply documentation- when I called the school, I learned it was legit, luckily just about $200, and that the agy that called me was, in fact, the one they had authorized. So, I hope OP has called CMS or her local med assn, for futher info.</p>
<p>Calla, that’s what some of the links are about. It’s not assuming fraud, but errors. There is also a process by which a provider can contest. I wouldn’t say “on a whim,” since it still has to follow procedure. But, I suppose it’s a mess for some with multiple errors.</p>
<p>Medicare would really complain about $15?</p>
<p>I’d ask for documentation along with the name of the collection agency, their phone number and the name of their lawyer and then check them out including asking the attorney general in their state about them. I’d also ask for a copy of the original bill.</p>
<p>I’ve never been chased down by a collection agency - the only thing close was someone that called our household looking for someone with a similar name. They bothered our answering machine for a while and then went away.</p>
<p>This sounds like a scam to me. I would insist on receiving a letter in the mail, preferably sent either certified or registered with all appropriate documentation that you can review and share with your attorney.</p>
<p>I wouldn’t send money off to anyone based on a simple phone call. Unless and until they prove they’re legit, keep your wallet closed tight.</p>
<p>Op,
Be wary. It may be a scam so they need to provide full documentation: name, DOS, ICD9 code that H billed, and the ICD9 code that they think is more appropriate, etc.
However, there are these “audit” companies that have been running a fine tooth comb to try to catch billing mistakes over the past few years particularly with Palmetto Medicare. Also double check the statute of limitations for a company collecting on the overpayment. It is probably different than the years required to keep the patient’s chart. </p>
<p>I would def try to argue it. When MDs bill Medicare, and they don’t pay for whatever reason (they think its unilateral instead of bilateral, or whatever) and they keep stalling for 1 year, then after 1 year time, Medicare refuses to pay, citing untimely filing of claim (though it has been filed multiple times). So it should go both ways, esp since it is 9 years. Ridiculous.</p>
<p>Op,
Just saw Shrinkwrap’s post about the statute of limitations for Medicare overpayment going from 4 years to 10 years starting on Feb 2012. Thus, if this is truly one of auditing firms, they probably started combing for charts since this passed in Feb 2012. Prior to this change in Feb 2012, the old records would be outside of the statute of limitations.</p>
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<p>According to your post, they discovered the error in 2006. Thus IN 2006, they went back X years. If X is within the allowed time period, then the obligation is real - as of 2006.</p>
<p>Now, whether they have a claim today …
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<p>A creditor must do certain things to keep the obligation “legally collectable”. For instance, if they never try to collect for 7 years, many places will deem the debt no longer legally collectable (you may have a moral obligation, but not a legal one). I believe in some areas, the time frame is as short as 2 years. When I say “try to collect” I mean as little as sending you a letter.</p>
<p>Thus, your debt to the school may have been real (you did have an obligation to them). Whether that debt is legally collectable by the School, or the over billing collectable by the Government, depends upon whether they can prove that that they complied with the statue of limitations to keep the obligation legally collectable.</p>
<p>Sure sounds like a scam to me! And a pretty clever scam at that; the believable part is it is based on the inefficiency of Medicare collections - a very believable premise, plus a small enough amount so that the easy thing to do is just pay it. I bet they have a pretty high “hit rate” in the scam world. Please humor us and don’t pay without receiving written documentation.</p>