Malpractice in the Medical Collections Industry

Malpractice in the Medical Collections Industry

The Webster’s dictionary definition of malpractice is a “dereliction of professional duty or a failure to exercise an ordinary degree of professional skill or learning by one rendering professional services — which results in injury, loss, or damage.” Within the last few years, the FDCPA and the CFPB have rallied together to establish newer laws protecting consumer rights and the interest of integrity in the field of collectionsOne of the many additions made through the CFPB was the launch of a system to accept and assess complaints made by consumers. The results after just months of submissions were staggering, opening a new window to aggressive tactics and negligence in the collections industry at the consumers cost.

Medical debt is among the most common types of debt for collection agencies, falling second to credit card debtAccording to a 2016 New York Times survey, medical debt affects roughly one in four U.S. adults, resulting in nearly 40% of debt collected in the industry. An interesting discovery regarding the results in complaints made to the CFPB is that “ten companies account for 20% of all medical debt collection complaints.” In the case of medical collections, the old saying “a few bad apples can spoil the whole bunch” surely holds more merit than assumed. As a method of taking action towards these “bad apples,” “as of February 2017, 139 debt collectors – including medical debt collectors – have been banned from further debt collection by the Federal Trade Commission.”

Diving further into the medical collection complaints received, abreakdown of these complaints shows 63% of issues recorded pertained to “alleged collection attempts for debt that was never owed, already paid, or never verified.” Furthermore, 37% of the issues recorded recognized “all other complaints, including allegations of aggressive and/or illegal behavior.” Amongst these complaints, several themes were found – mainly recognizing the validity of medical claims and the outcomes of clerical errors that can drastically effect the consumers credit report.

All too often the consumer’s rights are lost in the process of collections. At Cedar Financial, “Putting People First” is the landmark to the continuous success. Through the continued text, Compliance Manager, Syntheia Nagel and Collections Manager, Justin Franklin, provide noteworthy responses to how Cedar Financial copes with the ongoing themes found in medical collection complaints issued through U.S PIRG, Education Fund research.



v “Nearly two-thirds (63%) of complaints about medical debt collections assert either that the debt was never owed in the first place, it was already paid or discharged in bankruptcy, or it was not verified as the consumer’s debt.” (ES; 5)

 

 

What is the process Cedar Financial exercises to ensure our medical debt collection cases are verifiable? What is a common theme found in medical collection complaints?

Syntheia Nagel: Before responding to a dispute or request for verification, Cedar Financial will request proper validation of the claim from our client. This validation process provides us with the necessary information to show proof of debt to any consumer andauthenticates the claim for us to continue our collection efforts. If we cannot validate the debt with an accurate bill reflecting services rendered, we try to determine if we have contacted the right person. We have processes in place for both cases after we make that determination. Regarding medical debt, the most common dispute from the consumer is “I don’t owe this debt because it was covered by insurance.” What we want consumers to be aware of is that some medical costs are subject to an annual deductible, which is not covered by insurance. It is also important to note that Cedar Financial does not report medical debt on a consumer’s credit report.

v “Filing law suits against consumers whose debts are not verifiable or enforceable is a big recurring issue. In a case that the CFPB brought against two of the nation’s largest debt buying companies, an investigation found that the companies “filed lawsuits against consumers without having the intent to prove many of the debts, winning the vast majority of the lawsuits by default when the consumer’s failed to defend themselves.” (MDC; 9)

 

How does Cedar Financial provide verification for valid legal assistance?

Justin Franklin: Any claim that we recommend for legal efforts will have all necessary documents attached to validate the claim. The attorney networks we work with will not accept or litigate claims without the proper validation documentation thereby ensuring no consumers are wrongfully defaulted in the court of law.

“A World Privacy Forum report from 2006 estimated that between 250,000 and 500,000 people are victims of medical identity theft each year.” (MDM; 20)

In the simplest terms, how does Cedar Financial deal with identity theft? What processes does Cedar Financial follow to ensure consumers are not impacted by invalid debts?

Syntheia Nagel: : ID Theft is a horrible crime. We have and follow our detailed procedures in cases on ID Theft. In Summary, if a consumer notifies us that they have been a victim of ID Theft we ask then to complete an ID Theft Affidavit. We notify the Client, and update the Credit Report. We read all account information provided by the Consumer and Client as part of our investigation. Actions are taken based on the results of our investigation

“A 2013 FTC (Federal Trade Commission) study reviewed reports for 1,001 consumers; in the study, one in four consumersidentified credit report errors, one in five had a credit report modified after disputing an error, and one in 20 had errors serious enough to be denied credit or were forced to pay more.” (MDM; 10)

How does Cedar Financial correct file errors? Is there a system in place to catch clerical mistakes?

Justin Franklin: At Cedar Financial, we have an around-the-clock quality control department that verifies all files after they have been entered. This system is vital for ensuring mistakes like the ones listed above are caught far before anything negative can affect the consumer.

“In many cases, consumers may be pursued for debts they do no owe, simply because a payment was incorrectly entered into a billing system, an insurance company glitch delayed payment to the provider, or a name was misspelled when debt was sold to a debt buyer.” (Intro; 7)

How does Cedar Financial correct these types of “out-of-office” errors? What is the estimated time of resolution?

Justin Franklin: We ask for proof of payment. If our request for proof of payment is refused, we ask for details of when/how the payment was made. If that is refused – we still ask the client to review their file to determine if there was a clerical error on their end. During this process of determining the validity of any dispute the files are put on hold; ensuring the consumer is not negatively affected by error.

Source: U.S. PIRG Education Fund – Frontier Group; Weissman, Gideon; “Medical Debt Malpractice” Spring 2017