ClaimDOC Credit Advocacy

Regulation helps the process, but our experience drives the solution.

ClaimDOC has a unique situational awareness of and history with defending patients from healthcare providers who choose profit over patient care. The drive for profit has created a unique ecosystem where patients are treated not as patients, but as debtors. Healthcare providers are no longer providing healthcare. They are providing financing services and acting as full-on creditors entering into one-way contracts of adhesion with unsuspecting patient-debtors.

Fortunately, this is not entirely the wild west and regulations have provided a much-needed source of framework for defending against these abhorrent collection practices. Chief among the possible “extraordinary collection actions” an agency could pursue is the furnishing of a negative remark on a patient’s personal credit report.

ClaimDOC has a team of dedicated balance bill specialists and in-house attorneys who specialize in resolving issues like improper credit reporting. The team has several means for fighting against such actions and below lists the tools and resources at their disposal.

External/Regulatory Tools Designed to Protect Patient*

  • Fair Debt Collection Practices Act (FDCPA) and its various state modeled acts
    • Provides the framework for how consumer debt may be permissibly collected
  • Consumer Financial Protection Bureau; State Attorneys General; various other government channels
    • Enforces consumer protection laws and creates/interprets consumer laws; adjudicates and enforces consumer complaints

Internal Healthcare Provider Policies

  • Typically, a (or many) published documents describing a provider’s policies related to financial aid, debt collection, and billing practices

Internal Process and Tools to Protect Patients

  • Determining the proper path forward includes: researching bill, the provider, the provider’s agents, and the state in which services were provided
  • ClaimDOC’s experience with providers and various third party collection agencies, and our knowledge of the colloquial rules governing that locality helps us defend bills and potential credit impairments proactively
  • Through our advocacy program, ClaimDOC is able to analyze the many provider policies, rules and regulations, and various state peculiarities and then provide solutions adapted for that specific situation. This includes educating various third parties (provider, patient, collection agency); filing complaints to various state and federal agencies; more aggressive offensive tactics include lobbying the public and publicly demonstrating the provider’s abhorrent tactics and litigation.
  • In certain situations, resolution of an improper impairment is best done through settlement                         
  • ClaimDOC’s team is highly capable and experienced in analyzing claim level data, applying the ClaimDOC program and plan requirements to the balance bill in question and ensuring any settlement-based resolution is within plan requirements and/or possesses the requisite approvals.

*Forthcoming 2021/22 – The No Surprises Act – An Act to ban surprise medical bills; CFPB issues (1) Final Rule on Consumer Disclosures Related to Debt Collection and (2) Final Rule to Implement the Fair Debt Collection Practices Act