Thursday, June 30, 2016

The Follies: Medical bills and insurance

Always good for a laugh

Jeff Epton
3735 17th Place NE
Washington, DC 20018

June 30, 2016

Laboratory Corporation of America
PO Box 2240
Burlington, North Carolina 27216-2240

Re: Invoice # 00356327

To whom it may concern,

Over the last nine months or so, my son, Brendan Epton (17 years old at this time), has periodically received collection letters from your subsidiary, LCA Collections. Being a minor, Brendan is not actually legally liable for a medical debt. His parents, Marrianne McMullen and I, who reside at the above address with Brendan, are, in fact, the liable parties.

In light of the above information, it seems that if you continue to feel the need to send dunning letters in regard to the outstanding bill, you should address those letters to Marrianne and I.

But, perhaps before you do so, you should make an honest effort to identify and address the obstacles that might be delaying payment for your services. May I submit the following as suggestions and/or information that might guide how you proceed?

First, though I have no actual knowledge of why Blue Cross Blue Shield of North Carolina refused to pay the bill you submitted, I have been told that they needed a formal affirmation that Brendan was, indeed, a qualified dependent on Marrianne’s BCBS insurance policy.

If that is the case, and we have received notification from either LCA or BCBS that they wanted us to speak up and affirm, then it is definitely our bad for failing to do so. However, if neither you nor BCBS followed up by asking us to make such an affirmation, or repeated the request as often as might have been necessary, than one or both of  you was certainly being sloppy about the whole matter, if not negligent.

Still, as it happens, some months ago I did contact NC NCBS and made that affirmation. And so the matter was settled. Not.

Another two or so months after my long, long, long phone conversation with BCBS (punctuated, as it was, by repeated and demoralizing hold messages), Brendan (still a minor), again, began receiving collection letters from LCA Collections. Again, I contacted NC BCBS to ask what difficulties might be keeping them from processing your bill.

I can’t help asking what you were doing meanwhile to address the problem, other than, perhaps, preparing to send out another of your stunningly effective collection letters. But I digress.

In any case, NC BCBS told me that they did not have a physician’s authorization for the tests on record. I will not outline precisely what followed, as it is described in detail in the message reprinted below that I just minutes ago e-mailed to NC BCBS, but it should suffice to say that I stayed on the line for even longer this time while the NC BCBS representative contacted Brendan’s doctor (Laura Hofmann, (202) 797-4950) to obtain that authorization, retroactively.

That done, I assumed that when and if we again heard from LCA, it would be to pay whatever balance remained after BCBS finally processed your bill.

But, much to my surprise, Brendan (still a minor) recently received yet one more collection letter from you. You must be so proud.

Finally, I will add that the LCA facility where the tests were conducted is based in Dr. Hofmann’s office! How hard could it be for LCA and NC BCBS to figure out how to put this matter to rest?

Sorry. I know it doesn’t help to shout. Below is the message that I sent to North Carolina Blue Cross Blue Shield today.

Please don’t get the idea that we are tired of dealing with you guys. As we all know, into every life a little rain must fall. Nevertheless, you people at Laboratory Corporation of America (and Blue Cross Blue Shield) ought to improve your business practices, particularly billing, bill processing and collections. After all, you are in business to get paid and, if you don’t do better than you are currently doing, you ain’t ever gonna get paid.

Jeff Epton


My message today (verbatim), to North Carolina Blue Cross Blue Shield:
“The member ID is actually for Marrianne McMullen, Brendan's mother and the person to whom I am married. We live in Washington, DC and are enrolled in the Federal Employee Program.

“I am writing in regard to a bill for laboratory tests ordered by Brendan's doctor, Laura Hofmann (202) 797-4950) in the fall of last year. The bill was submitted for payment to the NC Blue Cross Blue Shield (BCBS) by the Laboratory Corporation of America (LCA), apparently because LCA is an NC-based company.

“The bill has never been paid or, to my knowledge, properly processed. After receiving collection notices from LCA for Brendan (a minor, who cannot be legally liable for the debt), I contacted BCBS to ask why the bill had not been paid. I was told that was because there was some NC regulation that required that Brendan be identified annually as a qualified dependent on the insurance plan. When I spoke to an NC BCBS representative and formally claimed Brendan as a dependent, I was told that the bill would be processed.

“When some time later, LCA resumed sending debt collection letters, I again spoke with a representative from NC BCBS who told me that there was no record of a doctor ordering the tests for Brendan. After I explained my frustration with the process to that point (some six months or so after the tests were conducted), the NC BCBS representative kept me on the line while she contacted Dr. Hofman's office directly to complete the record. At the conclusion of that call, the representative told me that everything had been taken care of and that the bill would be processed.

“Now, some two months later, I sit here with another collection letter sent by LCA to Brendan, who is still a minor. I am writing you now because I have absolutely no desire to spend another minute, let alone an hour (which is how long I was on the phone last time) with an NC BCBS representative.

“It strikes me that this whole situation is no fault of anyone in our family, but a consequence of an insurance company's failure to conduct its ordinary business in an appropriate fashion, but what do I know?”