The Debt Collector

by Norman Reisman

About 9 months ago I had this terrible cough. It just wouldn’t go away. My doctor kept trying different things. Inhalants, cough suppressants, expectorants, lozenges…..nothing worked. He finally sent me for an X-ray just to make sure I didn’t have pneumonia and thankfully, I didn’t.

A few weeks later I received the usual batch of EOB’s (Explanation of Benefit Forms) from Medicare and I saw that the claim was rejected for reason # H, “Routine care is not covered.” So I called the lab and explained that this was not routine and they resubmitted the claim. I received another EOB shortly thereafter also indicating that the X-Ray was not covered for reason # H.

I decided to check with my doctor’s office. They could certainly explain this to the lab. My doctor’s office manager informed me that it was a coding error and she instructed the lab on exactly which codes to resubmit the claim under. Meanwhile, I was speaking regularly to the lab trying to get them to understand that I didn’t just feel like having a chest X-ray that day. I had a serious cough and my doctor needed to see what was going on. It was definitely not routine.

I then started getting texts from a collection agency. “Norman, we need to discuss your balance of $93. Please call us at……”. It was signed, “Debt Collector.” Meanwhile the claim continued to get rejected. The lab then told me to contact Medicare myself and explain it to them. I discovered that you can dispute a Medicare rejected claim by following a certain procedure, which I have now tried. (Results are pending Medicare’s review.)

But I still needed to make this dreaded call to the Debt Collector. (The last thing I needed was to get yelled at over that damned $93.). So I called. A very nice woman answered the phone speaking the most perfect English that I’ve ever heard from a customer service person. “Hello, Norman Reisman. We need to just verify your identity before we get started. Please give us your date of birth and zip code,” which I did.

“Thank you. Are you calling about the $93 owed to Lab X?” She responded.

“I am.”

“Great. Would you like to pay that with a credit or debit card?”

“I just called to let you know that I’ve written to Medicare…..”

She then repeated the last line about how I’d like to pay so I asked, “Are you a real person or a recording?”

Her response was that she was a “Virtual Customer Care Associate” and asked if I had any other information for her. I explained what I was doing regarding the dispute with Medicare and as soon as she heard the word “Dispute” she said, “Oh, you’re disputing the claim. We’ll remove you from our active collection list and await the answer.” (Some words to that affect.)

My cough has been cured for many months now. The claim remains unpaid but at least it’s under review so I’m happy about that. But I must admit, even though our interaction was brief, I do miss my virtual customer care associate. I never even got her name.