My wife went to have an elective procedure in outpatient. She asked three times if this was only a $60 copay. They said yes and gave her a sheet that showed her (highlighted) it was only a copay. She paid the $60, got a receipt saying there was no balance, and had the procedure done. Two months later, she received a bill for $1400. I wrote them explaining the above, stated it met the five standards of equitable estopple, and I wanted the bill dismissed. I just got a final notice to pay in thirty days or it will go to collections. If I pay my bill in full so it doesn't go to collections can I still take them to court for the money back? Do you think I can win this in court?
Thanks in advance
2 Answers from Attorneys
I must ask if the elective procedure was covered by your insurance ? Was it approved pursuant to the insurance policy. If the insurance refuses payment, you may be liable for all the cost of the elective procedure.
Assuming you did everything right; however they improperly billed and failed to collect for their own deficiencies, then you should not pay and bring a claim under the Fair Debt Collection act. Note that Collection agencies cannot cause you harm if you contest the debt properly.
I suggest you contact your local FDCA attorney and get further advise.
A review would need to be done of your insurance policy. Also, have you contacted your insurance company, shown the documentation, and explained the situation to them? Often times, the insurance company can help resolve the issue if you escalate it. I have also had success in contacting the Florida Department of Agriculture and Consumer Affairs for issues similar to this. Contact the collection agency and let them know you are disputing and to hold off on pursuing collection until the matter is resolved; they will likely put a hold on the collection for a short while. What I described would be the quickest and least expensive route should it work. If still unsuccessful, you can look into bringing a claim under the Fair Debt Collection Act.