I won. They admit to never sending bills or collection notices as required by law and then never sending the demanded detailed billing and validation of the debt as was required by law. An oral request is deemed a valid request by a consumer. Therefore they never satisfied the standards of federal and state consumer collection laws.
I also won the statement that their bill was unreasonable and violated the laws of an implied contract to bill me at reasonable rates (you must know the detailed insurance calculations for this).
I got a complete understanding of the insurance calculation which you must know the details to if you want to win on the argument the bill was not Reasonable (your best defense along with debt collection laws).
Now it's about getting the case dismissed by them and ensuring they can't sue for any more than I had always agreed to pay. I won as in not having to pay more than insurance standards but, I still lost because it took hours of finding my rights and searching all the legal databases and forums out there. Not to mention the dinners I owe to a number of attorney friends.
Thanks to anyone who helped. You were right about HIPAA although it does serve to strengthen the case. Not to mention mailing letters to the hospital about the unconscionable billing well in excess of R&C which violates HIPAA standards although is not enforceable. The hospital should be told if someone is charging exorbitant rates as they do care and will most likely want to know if doctors use threats and unreasonable billings.
The best defense is knowing in detail how insurance company settled their amounts as you have to prove their bill was not reasonable if you go to court. Yes, sadly the burden is on the Defendant for proving the bill isn't reasonable. If they didn't do any thing that was outside the norm of the insurance company range or actually did less than the average service required you do have a case to argue the bill should be well in the range of the database your insurance company uses otherwise the bill is unreasonable. They can't bill you whatever they want and the law says you created an implied contract at time of services and that implied contract (unless you are specifically told and signed that they will charge you in excess of reasonable) then they must only charge you reasonable rates. Please note the letter they make you sign to provide services only stipulates you'll pay if the insurance company doesn't and does not give them the rights to bill you outside Reasonable.
If anyone is interested I can be more detailed at another point. I don't have the time to be exact. Just know that you do not need to give in to outrageous demands and can win if you know your rights. I now feel it is my duty to help those like me who are being unlawfully forced to paying exorbitant rates.....
I need to get my life back now. My house is a disgrace and home cooked meals have been a thing of the past. Ah and sleep, I can't wait to sleep a full night without thinking of something else I could use as a defense....
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