What would you do...collections threat.

So here’s the story. My wifes family, her entire family (her, brother, both parents, all four grandparents as well as all included cousins) all use the same ENT. He is a very nice person, nice enough that I’ll bet a good chunk of his patients would consider him a friend, or at least something more then an aquintence. On top of that, my MIL being in the medical field herself seems to have an even closer connection with him. So when I was in need on an ENT I saw him. I really do like him, he’s a very nice person. After the first appointment he told me to come back in three weeks. Before those three weeks were up, I received his first bill. I think it was about $150. I made a $75 payment on it. At the second appointment. I explained to him that I’m on an HDHC plan with an employer funded HSA. At the time, my employer was putting $150/mo into my HSA which had to be split several ways. I told him all this and then told him that if his appointments are going to be $150/mo either we need to space them out to every 5 weeks or so (rather then every three) or we need to talk about getting a lower price since I simply couldn’t afford it. He mentioned that the first one was expensive because it was an initial consultation, but the rest would only be about $60. Phew. So each appointment I got a bill, and each time I got a bill I paid $50-$75, whatever I could afford that month with what I had in my HSA. This has been going on since January with no problems. In June he gave me “three months off” and I have to see him again in September. When he said that, I joked that I’d have him paid off by then. So I get a bill in June, I send in my check. For some reason though, the check hadn’t cleared my bank yet. In fact, I was going to call on Monday to see what’s going on with that. But today I got a statement from them, on it they circled “Last payment 5/21” and wrote a note that said “3rd notice, Avoid collection.”
Now, I can understand that something happened between me writing the check, and them receiving it. Maybe I lost it, maybe they lost it, who knows, who cares. But it seems to me a call would be in order. This “avoid collection” note seemed rather out of line. And on top of that, I would hardly call this the “3rd notice” I suppose my May bill/statement was the first, my June statement (no appointment that month) was the second, and this, my July statement, was the third. But what she wrote on there was kind of a slap on the face.
I just wrote a check for the entire outstanding amount, but my question is, do I send a letter in with it explaing how I feel, do I just show the handwritten note to the doctor and tell him how insulted I am, or do I let it go?

I should also mention that even though I don’t pay the bill in full each month, I do pay prompty EVERY month, I have never gone a month without making a payment, and they’ve never had to call me to ask when they’ll be getting their payment. I would think that if the way I was paying was an issue, they would have mentioned it to me sometime in the last 7 months, nicely. Not like this.
For example, my wife saw a doctor quite a while ago, the bill was several hundred dollars. I sent in about $50 and got a note back saying “Full payments only, to make a partial payment please call this number and set up a payment plan.” There that was easy.

How large is the doctor’s office, and is it a practice with other doctors in the same business? I think just about every doctor I go to has a dedicated person doing the billing, or uses a billing service. The notices are almost automated – even those that are prepared by a person who might add a note, it’s very impersonal. Third notice would get a note automatically. This probably works the best for the doctor, with a lot of patients, you would probably have to churn out the bills without much personal attention to keep on top of them. I would be surprised to receive a phone call – in fact, I would prefer not to. Having it in writing seems much better for both me and the doctor’s office. Phone messages are too easy to lose track of.

I am sure there are exceptions – my mom’s dentist is like that. The dentist’s wife does the billing, and it’s very folksy. This is nice, but probably not realistic for most practices.

It only the doctor, his wife and two or three people at the front desk. The bills come from, and get sent to the doctors office. If I had to take a guess, I would bet he has about 200 appointments per month. I don’t think I’ve ever seen another patient in there. In fact, he’ll often do the “How are you, how’s it going” small talk yelling down the hallway from another room.
I am also going to ask my MIL about the situation. She might have some insight as everyone there knows her. In fact when I bring my daughter she’s referred to not as Joey’s daughter, but as Arleen’s grand daughter. So they know who I am. I hoping she says something along the lines of “Don’t worry about it, the AR lady is an ass” but she’ll probably just tell me to mention it. Now, in two months when I have my next appointment, I’ll likely have forgotten about it, but at the moment, I’m rather insulted.

I wouldn’t be TOO insulted…I would think there’s maybe a bit of a billing mixup.

I do the books for my business. But I have an employee that does collections and also speaks on the phone (if you want to call about billing, you call him and he tells me). Sometimes, he’ll make a deal with someone over the phone regarding their bill. He’ll tell me but it is likely that I will forget, so I’ll occasionally send out a bill in error. Or, a standard “please pay now to avoid disconnection” notice. I’m not trying to be an ass to this person I am just trying to get their attention.

If I’m not alerted by my employee that I made a mistake in reminding this customer to pay up, the customer will respond to my billing email and I’ll be cool with it.

There’s a lot of billing to be done. I don’t mind if people need to work out payment plans with us (well sometimes I do but that’s a different story). What I hate the most tho is people who just ignore us. If they ignore us I can’t help them. I get quite pissed when I send out a third notice and THEN I get a sob story. First notice sob story is fine.

So, I would just explain to the office again. Perhaps not your doctor directly, tho - talk to whomever does their billing, or is the face person for billing. I’m guessing they’d rather hear your story than have it turn in to a huge mess of you not paying.

BTW - I have an HSA and I’m under the impression that if I don’t have money in the HSA right now, I can pay the bill out-of-pocket then cut myself a check from the HSA directly. Just as long as you keep good records of what happened you should be ok if you were to be audited. I’m not saying you have to do this but if it will save you some grief with the Good Doctor, maybe you should just pay out of pocket then cut yourself a check when you DO have the money in the HSA.

I’d cut the Doc some slack - billing is a Necessary Evil with small biz, and slip-ups can occur. I recently sent a bill for services which I had billed in February (and I was paid in March). I was quite embarrassed over the mixup but the client was very understanding. Mistakes happen.

Automated billing seems the likely culprit. Billing software has its limitations.

I do billing as well, I understand how things happen. But the way I see it, I missed one months payment. One month. I don’t think missing a single payment warrents “3rd notice, avoid collection” I think missing one payment warrents sending out another statement or giving me a quick callm or what I write on statements that are going to customers that don’t seem to want to pay “Please send a check.”
The part that insults me is that she’s threatening to send me to collections over a single missed payment. I’m sure I’ll just let it go, in fact I really hadn’t given it much thought since yesterday. I’ve already written the check for the full amount, I’ll just move on.

As for how HSA’s work, yes, I can just write the checks out of my pocket and then reimburse myself later. But most doctors let me send in what I can each month, so I try to just limit it to what’s in the HSA.

Is it possibe they out source billing? It could be outside accountant that does billing for a number of businesses. All they care is that the bills get paid.

So here’s what I’m gonna do. I going to send the check, but along with it I’m going to enclose a letter that simply says that I thought I had sent them that check, so if they do find it please destroy it since I’ll be closing that checking account soon. BTW this is true. I’ll hopefully be opening a new HSA and rolling everything over to the new one. I’m concerned that if they lost the check and it turns up after the account is closed I’ll wind up getting charged a bounced check fee. I’m sure they’ll disregard the letter, but if it does turn up, maybe they’ll at least notice that I don’t owe anything and call me about it.

Keep a copy of the letter you send them for your records, in case they do cause you a bounced check fee and you decide to seek re-imbursement from them for it. :confused:

Seems the problem was caused by you, not the doc. Step up to it like a mench. Pay what you owe with neither excuse nor complaint.

What makes you say that???
I might have forgotten to mail it.
It may have gotten lost or damaged in the mail
The office may have lost it.
Seriously, what made you decide that it was ME. I’m not saying it’s not possible, I just want to know how you came to that conclusion. And who said I wasn’t planning to pay it, I speficially said in this thread that I was writing a check for the entire amount. (What I wrote the check for last month, plus what I would have written for this month would equal that anyways).

And what’s a mench?

PS I have every right to complain. I’ve made a payment every month since January (when my first appointment with him was), one payment got skipped for one reason or another and they threaten collections. That’s out of line in my book. Like I said before, a phone call would have been the way to go, or a polite note on my bill.

PPS I checked it out and the billing IS done in the office, it’s not out sourced.

As I understand it, up to now you’ve talked only to the Doc about billing and payments. Given that, I would have a word with the Doc, apologize for the missing payment, and express my surprise at getting a “3rd notice” indication and especially at getting a collection threat. As the conversation warrants, you can mention how it seems unduly harsh under the circumstances and/or how you actually found it rather insulting.