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  1. #1
    Join Date
    Oct 2011
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    Question Patient Taking Office Manager to Small Claims Court

    My question involves collection proceedings in the State of: Virginia

    In a nutshell, I was the office manager of a clinic. The doctor retired and sold the practice. A former patient wants a refund. He has filed a small claims suit against ME. More info: I am the doctor's wife; however, the practice was a sole proprietorship. As just an "employee" of the practice, I believe I can't be held responsible for anything owed to the patient and can't imagine the suit won't be thrown out on those grounds. However, this man and his entire family (parents, aunts, uncles, children, etc.) were patients for years and I would like to settle this amicably, if possible.

    In 2009, his co-pay changed and my front desk person missed that (and, apparently, he did as well). He continued to pay his old co-pay, which was not enough. In 2010, he paid the correct co-pay; however, he apparently met his out-of-pocket, so the insurance paid 100% for 2010. All insurance claims were filed and processed and network write-offs were taken... When you combine the two years, there was a small refund due and this was paid to him. However, he wants the entire amount for 2010 returned. He feels that, because WE didn't tell him he was underpaid for 2009, he shouldn't have to pay us the extra money for that year. It gets better. On his "warrant in debt," he has put the amount for 2010 PLUS 20% interest, PER MONTH, compounded monthly and, of course, the court fees. So the $300 he thought he was owed is now listed as $3000!

    Naturally, *I* owe him nothing because I was an employee. I am also aware that, even if the money was owed, he is not going to get 20% per month interest. Here are my questions: 1) Can someone point me to the Code that says we are REQUIRED to collect the patient portion so, even if I wanted to, I can't let him NOT pay what he owes for 2009? 2) What is the statute of limitations for medical debt collection in Virginia? (He think it is too late now for us to say he owed the money...) 3) If the money WERE owed, what is the proper interest rate to be charged? 4) Any other comments someone thinks would be helpful. I am hoping that, if I show him we are REQUIRED BY LAW to collect the money owed for 2009, he will drop the suit.

    Oh, one more thing. Do I really have to show up in court for this? It is over an hour away. This situation has my stomach in knots.

  2. #2
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    Sep 2005
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    Default Re: Patient Taking Office Manager to Small Claims Court

    You should defend against the lawsuit by asserting and documenting that you are an improper party, if necessary bringing a motion for summary disposition.

    No creditor is "required by law" to collect a debt. A creditor may, as appropriate, choose to take a loss or write off a debt.

    If you believe you are contractually required to collect the patient share by virtue of your contract with the patient's insurance company, you will need to review the terms of that contract.

  3. #3
    Join Date
    Oct 2011
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    9

    Default Re: Patient Taking Office Manager to Small Claims Court

    Thank you. I guess the "law" to which I was referring was that which says you can't have a "dual fee schedule." Having NOOPE (no out-of-pocket expense) is not allowed, and that is what he is asking me to do. He wants me to accept less than the fee billed to the insurance company (by writing off his portion). Maybe not, but i have been told countless times that this is not allowed. Plus, yes, we were contracted with the payor (BC/BS) so I need to find that contract. As I said, we sold the practice a year ago and all those papers are in storage.

    Oh! And I discovered this is NOT "small claims court"... Apparently, since his computation of interest puts the total at approx. $2800, it doesn't qualify as "small claims" (<$1000). So I guess I am being sued in "real" (General District) court.

  4. #4
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    Mar 2005
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    Michigan
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    28,906

    Default Re: Patient Taking Office Manager to Small Claims Court

    The Virginia code is available here. The most likely places you would find such a law, if it exists, is under the sections for insurance and professions (specifically the subsections relating to health care professionals and insurance). If there is no such law in your state, you'll end up doing a lot of browsing and searching before giving up; I suggest asking around among your professional contacts or perhaps asking an insurance adjuster for pointers.

  5. #5
    Join Date
    Feb 2010
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    CT & IL
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    5,273

    Default Re: Patient Taking Office Manager to Small Claims Court

    20% per month??? Really?!!?!!?? You seem willing to settle this matter. I would recommend you just pay him back the $300 or absolve the debt. You CAN do this. He may not drop the suit and in small claims anything can happen. If you are listed as an officer for the company, a judge may find you are a proper party. Your business may be guilty of excessive usury. Its $300 ... worth the hassle?

    Otherwise argue standing .. then if you lose, be prepared to answer to a judge for the 20%/month interest rate; I'm sure the judge would love to hear your explanation as to how you think this is acceptable.

    I never pay a doctor if they do not solve my medical issues , like a garage mechanic who works on my car. I'm sure the patient has had some issue with the level of care or a complaint of the costs or your administration of the medical billing.

    If you were to charge me 20% per month, you have more than a small claims case. The patient may figure this out and drop the small claims and file a regular suit. Plus, he can always re-file either way in small claims or regular court if the judge finds in your favor regarding the standing --- it may be in your best interest to let the claim be adjudicated in a small claims venue.

    Quote Quoting RetiredOM
    View Post
    Apparently, since his computation of interest puts the total at approx. $2800, it doesn't qualify as "small claims" (<$1000). So I guess I am being sued in "real" (General District) court.
    He can still file in small claims but he would be limited to an award .. he can list greater than that (maybe he loses the points on some things). You can call the clerk and see if it is small claims.

  6. #6
    Join Date
    Oct 2011
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    9

    Default Re: Patient Taking Office Manager to Small Claims Court

    Thank you. I wish I had time to look because I think it is there. However, I have spent the last two days at the vet's... after extensive diagnostic testing, my kitty has been diagnosed with cancer and does not have long to live. The last thing I want to deal with right now is this mess. However, I do appreciate the help and you taking the time to send me the information.

  7. #7
    Join Date
    Oct 2011
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    9

    Default Re: Patient Taking Office Manager to Small Claims Court

    I was advised by an attorney to not send him a dime. I have no clue what to do now. He said that, since the patient has sued me for $3000, sending him the $300 will not satisfy the suit and could be construed as an admission of guilt at some level. I am not an officer of the business, as this is a sole proprietorship. As to the 20%, I think you misunderstood. The patient has charged ME 20% per month interest! IF I owed him the money, which I don't, he has figured $300+ dollars, over eight months, at 20% per month, compounded monthly, to arrive at a figure of almost $3000! As to his medical issues, he has been a patient (as well as his entire extended family) for 30 years. There has never been a problem or a complaint until now, so I think I can safely presume he was happy with the care. He is just not happy that I am not refunding money that he owed. As you noted, I would be willing to give him the money just to avoid going to court; however, as I said, I was advised NOT to do that... so I guess I'm headed to court. Thanks for the advice. I appreciate you taking the time to answer.

  8. #8
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    Oct 2006
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    supratentorial region
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    818

    Default Re: Patient Taking Office Manager to Small Claims Court

    I never pay a doctor if they do not solve my medical issues , like a garage mechanic who works on my car.
    Hmmm....but don't you have to pay the mechanic BEFORE you are given back the keys to your car? Just saying.

    In 2009, his co-pay changed and my front desk person missed that (and, apparently, he did as well). He continued to pay his old co-pay, which was not enough.
    Who posted the payments directly off the EOB? The error should have been picked up at that time. Having said that, the patient received an EOB as well and should have seen the error. Most BC/BS policies require the patient/consumer to pay their "responsibility" within 30 days.

    I am hoping that, if I show him we are REQUIRED BY LAW to collect the money owed for 2009, he will drop the suit.
    Yes, we are required by law to attempt collection of debt, but pointing that out to him probably won't help convince him to drop his suit. You will have to be present in court for this. Make sure you go prepared with all copies of 2009 & 2010 EOBs, any bills/statements sent to the patient and a copy of your refund check (which I assume was written in a timely manner). I do have some experience collecting medical debt through courts in VA. If you'd like to PM me, I'd be happy to share.

  9. #9
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    Default Re: Patient Taking Office Manager to Small Claims Court

    Quote Quoting davidmcbeth3
    View Post
    If you are listed as an officer for the company, a judge may find you are a proper party.
    This was a sole proprietorship, and the OP was merely an employee, so that's simply not going to happen.
    Quote Quoting lealea1005
    View Post
    Yes, we are required by law to attempt collection of debt....
    Please share a citation to the statute.

  10. #10
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    Default Re: Patient Taking Office Manager to Small Claims Court

    Please share a citation to the statute.
    It's buried in the copious Medicare regulations which are also followed by most insurance companies. I'll try to find you the actual wording as it refers to a medical office, but this is a good start as we are "contractors":

    http://oig.hhs.gov/oas/reports/cms/a0102003.pdf

    here is another relating to hospital/facilities:

    http://www.passavanthospital.com/_da...isfinalweb.pdf

    hope it's helpful.

    This was a sole proprietorship, and the OP was merely an employee, so that's simply not going to happen.
    I'm thinking she signed the reimbursement check to the patient, so the patient thinks, since she's the wife, he can go after her.

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