How did I end up in a collection agency?
It is important to know and understand the specific terms of your insurance policy and coverage limits, in order to avoid action from a collection agency. Most creditors, such as physicians, hospitals and other specialized medical providers will alert you to any outstanding unpaid balances. After a predetermined period (typically 90 to 120 days) without payment, the provider has the option to pursue debt collection with an outside agency such as MedConn.
Insurance Coverage Policy Changes:
A revision to your health insurance policy that alters or changes the coverage and services offered to you. This might result in a change in employment benefits, coverage limitations, or termination of benefits altogether.
Insurance Coverage Lapse:
There may be a time in which your health insurance coverage was not in effect due to loss of employment, change of employment status, change in insurer, or a failure to meet the premium payments. Any loss during this period will not be covered by your insurance company.
Most insurance companies require a minimal payment for medical services. The co-payment amount is determined by a percentage of the charge for the services rendered, or a fixed dollar amount determined within the terms of your specific policy.
The deductible, or, the fixed amount of money that will be required out-of-pocket to cover medical services before the insurance will consider further coverage. Deductibles will vary depending on your policy terms. After your deductible is met, your insurer may begin to pay covered medical services.
Your medical insurance company has time limits with which you must submit your claim for payment after medical services have been provided to you. Failure to submit complete and accurate information within specified time limits may result in denial of your claim. You may be able to appeal this determination once the denial is received; ultimately you are responsible for the payment of the claim should it continue to be denied.
EOB or “Explanation of Benefits” Forms:
This is a determination of what your outstanding balance will likely be once all deductible and co-payment coverage have been applied to your account. This may or may not include all insurance coverage and is a detailed list of what has and will be billed to the insurer and you.