Is what they did even legal? (Accounting rant)

[Jean in Newcastle]

I have a long history of trouble with my chiropractor's billing department. I even left him for about a year over it. But he is wonderful and one of the few doctor's who actually helps me with my fibromyalgia. That and he got a new wonderful accountant who was actually giving me accurate bills. Until now, that is.

 

I got a bill for over $500 for charges I had already paid for. I used to work in accounting at one point in my varied work history and I carefully match each EOB to each bill etc. Not only that, they took my check which specifically was made out to my account with my account number and my account's invoice and applied it to my daughter's account. I called the wonderful accountant and gave her an ear full. Apparently I was not the first patient today to do so. She apologized and has made it right. She told me that recently the actual invoices were taken away from her and were given to "corporate". I am going to write a letter to corporate and cc. my chiropractor. So - all of this to ask - in my letter can I say that it is illegal to take a check made out to one account and apply it to another? even if it is my daughter?

[Acorn]

Is she a minor under your care? If so, I don't think it was illegal. I hope you get it straightened out.

[Jean in Newcastle]

Actually, I would have been just as unhappy if they had taken money matched to a certain date of service and an insurance code for an arm injury and had willy-nillly applied it to a different date of service and part of the payment for a leg injury for the same account. Not only is it sloppy accounting, but how can I as a patient know what I've paid for and what I'm still awaiting insurance confirmation on? How can I know that their bill is correct?

 

I have paid a lot of medical bills and NO other accounting offices make sloppy mistakes like that.

[suppleasthewind]

I used to go to my midwives for annual exams and I felt like I kept paying the same $5 copay over and over. I thought, well its just $5 and I am not going through my records. Then they sent a $5 bill to a lawyer and I got a nasty letter. For a bill which I probably paid twice already! i went through my records, told off the billing office and haven't gone back. I emailed my midwives and never heard back. They probably think I am nuts.

[LaxMom]

I think it's customary to apply payments to the oldest balance on an account, whereas you are paying by EOB, which may reflect claims processed out of order (just generally, not specifically in your case). So, I can see, if your daughter's account is a sub account of yours, where they would do that. That seems like an odd accounting system to me, though, just because what if multiple family members come in on the same date? That could be a posting nightmare.

[Jean in Newcastle]

I think it's customary to apply payments to the oldest balance on an account, whereas you are paying by EOB, which may reflect claims processed out of order (just generally, not specifically in your case). So, I can see, if your daughter's account is a sub account of yours, where they would do that. That seems like an odd accounting system to me, though, just because what if multiple family members come in on the same date? That could be a posting nightmare.

 

These were the oldest balances on the account. My daughter's account is a totally different number and is tracked separately by the insurance company. The only similarity is that I actually pay the darn thing. And yes, we do often come in on the same date but our co-pays are different (because she's a child) and so our payment for each date of service is different.

[usetoschool]

I have paid a lot of medical bills and NO other accounting offices make sloppy mistakes like that.

 

Then you have been fortunate. My doctor's office makes sloppy mistakes like that all the time. And that is all it is, just sloppiness. Sometimes I feel like I should get a discount for doing their job for them. I have talked (whined) to friends about it and many have had similar experiences. We loved our doctor but the staff, no so much. It happened with our dentist as well. We once got a bill, in December, for a whole years worth of services all at once after I had been inquiring about not getting bills for appointments.

[Jean in Newcastle]

We once got a bill, in December, for a whole years worth of services all at once after I had been inquiring about not getting bills for appointments.

 

That is what prompted me to leave his practice for a while in the past. Not only did they send me that year-long bill, they threatened to send it to Collections. I had documented proof of phone calls I'd made asking about my bill.

 

Here's a funny, though. After my chiro called me, apologizing and telling me that he'd fired the last worthless crew so please come back, I did. And his new accountant gave me a wonderfully accurate bill. I wrote a letter to him praising her professionalism. He framed it and put it on his wall!

Edited May 2, 2012 by Jean in Newcastle

[Butter]

No, not illegal provided your daughter was under 18 and living with you. What you write in the memo section of a check is not legally binding. Most systems will assign a payment to whatever is outstanding, oldest first (ETA: And most systems link all accounts together that are family with one responsible party for payment,). The person applying the payment *can't* do it any differently. It's actually a safeguard to prevent an overdue account for an active patient from going to collections since some systems also automatically send accounts with payment outstanding more than x number of days to collections.

 

FWIW, I started doing insurance and patient billing for a therapist office when I was 17. They had been *terrible* at keeping track of monetary things prior to hiring me. I hated that I had to bill people and insurances for things that might have already been paid. We had some very irritated patients (but a whole lot more who *did* owe the money, but had never paid). I learned how to calm people down and apologize profusely very fast. I had no control over what was going on. I was only doing what my bosses directed me to do.

 

BTW, do you actually owe that money? Or was the bill completely in error?

Edited May 2, 2012 by Butter

[Jean in Newcastle]

BTW, do you actually owe that money? Or was the bill completely in error?

 

I owed about $200 of it, which I've now written out a check for. The rest (over $300) I had already paid. As for my daughter's account, I never even received an invoice for her. So no, I'm not going to take their word for it that I owed that money for something else.

[Lovedtodeath]

Actually, I would have been just as unhappy if they had taken money matched to a certain date of service and an insurance code for an arm injury and had willy-nillly applied it to a different date of service and part of the payment for a leg injury for the same account. Not only is it sloppy accounting, but how can I as a patient know what I've paid for and what I'm still awaiting insurance confirmation on? How can I know that their bill is correct?

 

I have paid a lot of medical bills and NO other accounting offices make sloppy mistakes like that.

Our local hospital did the same thing. They made a huge mess of our bills, applying payments for our doctor to older hospital bills, and we were sent to collections for bills already paid! We usually use our credit card and it was nearly impossible to figure out what we actually owed.

 

We did not pay it either. The first we heard of the outstanding balance they had already ruined our credit by filing it with a collection's agency, and then I can't even figure if we owe it or not due to the fact that they do not apply a payment to the bill I was paying? We usually paid the bill for the doctor's visit on the day we received service. I don't recall ever going to the doctor and not paying... I always get the credit card out on the spot. If they had applied the payments to THAT bill then we wouldn't have had this problem. Ridiculous.

Edited May 2, 2012 by Lovedtodeath

[Butter]

I owed about $200 of it, which I've now written out a check for. The rest (over $300) I had already paid. As for my daughter's account, I never even received an invoice for her. So no, I'm not going to take their word for it that I owed that money for something else.

 

Sounds like they needed a lot of help in the billing department like the therapist office I worked for. It's a pain for the patient AND the person who comes in to take over the billing. Trust me. This I know very well. Did you request an invoice for your daughter's account?

 

And, as much of a headache as it is for you, I can almost guarantee that a letter to corporate is going to do nothing more than have someone glance at it and throw it away. This I also know from experience. I used to push for them to just write it off if a certain amount of time had gone by (some of these dates of service were 2-3 years in the past - that's how bad their billing had been!), but they always refused and insisted I keep on billing. The thing is, it DID bring in quite a few payments, many times what I was paid and it cost to send the bills, so it was totally worth it to them. In your case they may look at it and go "Well, she owed us $200 anyway" and decide it was 100% worth it even with having to adjust the other $300. That's how the therapists I worked for were. A billing error or odd application of payment may possibly be unethical, but it's far from illegal (and, as I said, most systems won't even allow a payment to be applied to a specific date of service).

[Jean in Newcastle]

Sounds like they needed a lot of help in the billing department like the therapist office I worked for. It's a pain for the patient AND the person who comes in to take over the billing. Trust me. This I know very well. Did you request an invoice for your daughter's account?

 

Yes, I've requested an invoice and it is being sent to me.

 

And, as much of a headache as it is for you, I can almost guarantee that a letter to corporate is going to do nothing more than have someone glance at it and throw it away. This I also know from experience. I used to push for them to just write it off if a certain amount of time had gone by (some of these dates of service were 2-3 years in the past - that's how bad their billing had been!), but they always refused and insisted I keep on billing. The thing is, it DID bring in quite a few payments, many times what I was paid and it cost to send the bills, so it was totally worth it to them. In your case they may look at it and go "Well, she owed us $200 anyway" and decide it was 100% worth it even with having to adjust the other $300. That's how the therapists I worked for were. A billing error or odd application of payment may possibly be unethical, but it's far from illegal (and, as I said, most systems won't even allow a payment to be applied to a specific date of service).

 

I absolutely know that corporate won't care. Last time I had this battle with them, I had the head of the accounting department say "I'm sorry that you are in a snit about this." Some apology. However, my chiropractor will definitely care. I am going to personally hand him a copy of the letter. He has the clout that I do not have.

 

[Jean in Newcastle]

I don't know if it is legal or not, but it doesn't strike me as totally unreasonable since you would still be the one writing out a check for her. I realize you wrote your account number on it, but I think if they pulled up your account your daughter's account would still be associated with it and then they would go ahead and apply it wherever.

 

It's definitely a good idea to check everything though. I've found many "errors" over the years. It's bad enough half the time they don't write down the details of the services they provided, just some random amounts or one total amount. I don't know why they need to be so cryptic. That always makes me feel like they are trying to get away with something.

 

About the legality - I can see that it isn't illegal and won't include that in my letter. I wouldn't care if the money was applied to my account and was applied to older bills (if there were any, which there weren't). I do care about things being messed up between the accounts. This isn't just because I'm anal, btw. It is because these accounts are paid for from an HSA account. I could be audited by the IRS for what comes out of those accounts. Not being able to show a clean paper trail for what each amount is paying for could result in fines for me.

 

Also - All for of us in our family go to this chiropractor. Fortunately they didn't mess things up between the other two accounts too. Can you see why I used to groan when I got their bills? I was so relieved when the new good accountant was hired. And then I was so bummed yesterday when I saw that things had gone back to the old sloppy way of doing things.