I am suited by a collection agency for my dental bill total $744 plus legal fee in Little Rock, AR. Now I am living in Fremont, CA. I do not think I can go to court for such a small claim. What choice do I have? Can I send in a friend to represent me? or ...? I am very upset by this damn thing. If I lose the case, can I turn around and sue my insurance company?
Below is the brief story:
I had a dental procedure in Little Rock, AR on May, 2005. I am now living in Fremont, CA. The list price for my surgery is 1920. My insurance's estimate before surgery is 1474. I had negotiation with the dental office before the surgery. I made my copay of 365 before surgery. I do not remember how much is the total price now since at that time I only cared how much I need to pay.
Below is the letter I wrote to judge, please point out incorrect part.
11/20/2006
The Honorable
The Municipal Court of Pulaski County Arkansas Civil Division
3001 West Roosevelt
Little Rock, Arkansas 72204
Re: Dental Bill Dispute
Dear Honorable Judge:
I tried my best to write to you this letter to explain the situation. If there is anything here in this letter sounds informal, rude, or careless, please forgive me because that is not my intention. I am a foreigner in this country, although I try my best to master English and American culture, this is very hard for me.
Background: I had a dental insurance that has a $50 deductible and 20% co-pay when I had the dental procedure in dispute: Gingiv Flap Proc.
Summery:
• The price for my surgery is not $1920. That is list price. I never agreed to pay that price. They do not have any document signed by me showed that I agreed to pay that price. Going with the insurance estimate of $1474 before the surgery. I only need to pay $294.8 (20% co-pay). After negotiation, they told me I only need to pay $365 out of pocket, that I paid before the surgery.
• Debbie is the office lady of dental office who decided that I owe them money. Debbie does not know what really happened, she did not work for the dental office when I negotiated with Sylvia and had my surgery. Her words on this legal matter should not be relied on. By the way, Debbie does not work for this dental office anymore.
• There is a discrepancy between the estimate and actual payout from my insurance company. My insurance company’s excuse is that we did not have a written estimate. I think it is Sylvia’s responsibility to obtain a written estimate. She is a professional lady working on insurance claims on behalf of patients. She should know better than me.
• I have a very good credit history and a decent relatively high paying job. I have a master’s degree. Everything in my life suggests that I would honor my social agreement. The fact is that I do not owe anybody else any money.
Explanation:
1. The price of my dental bill ($1920) in the claim is the list price, not negotiated price.
I was given this price the first time I was told I need to have this procedure after I had x-ray on 4/21/05. I obtained the dental procedure code and got an estimate from my dental insurance on 4/27/05. The estimate was $1474. This transaction is on the insurance company’s record. I informed the estimate to Sylvia, the office lady in the dental office. I told Sylvia the list price is too high compared to insurance estimate. I was surprised at such a big discrepancy. Sylvia checked with my insurance company and negotiated with me. Finally she told me that $365 is all I need to pay. So I paid that amount before I had surgery. When I paid the bill before the surgery, I was pretty sure the price would be the last thing for me to worry about after several round of negotiation. So you can imagine how surprised I was when I got a call from Debbie asking for more money. I was even more surprised to see that the list price instead of negotiated price was there in the claim.
2. Debbie does not know anything about my negotiation with Sylvia but she asserted that I owe her money
Debbie was not there when I negotiated with Sylvia and had my surgery. Debbie was the lady who decided to forward my account to collection agency. I do not understand on what ground she reached her conclusion that I owe her money. Debbie does not know anything about this procedure, she does not even try. You can see it in the following evidence:
a) Debbie added an $85 charge for post surgery eval. Sylvia did not file claim about this charge with my insurance company. If there was such a charge, I am sure Sylvia would file a claim and I would have paid my co-pay during office visit. I made co-pay for my X-ray and surgery on the spot. I would have done the same thing if I think I owe them 85 bucks. I had never heard of such a charge before Debbie came into the picture. I had always talked with Sylvia about the price of the whole procedure. I would not want to be in a difficult situation that Dentist can add whatever charge he/she feels like.
b) From the beginning Debbie was talking about the list price. She was not aware of the negotiation happened between Sylvia and me. She denied the negotiation at the beginning. Then some day later, she suddenly told me she found that Sylvia had a discount for me written down in some book. You can see from the patient transactions that a discount of $206.5 was recorded on 8/2/05, about 3 months later than the surgery took place. If there was a discount, it should be recorded before or when the surgery took place. To be honest, I do not remember the exact discount number. All I cared about at that time was what out of pocket co-pay I would have to pay, which was $365.
c) At the beginning she did not even know the second check from my insurance company was lost in the mail. She did not even bother to check with insurance company and that is why she was not aware of the lost check. In the patient transactions in the legal document, it still says “Ins. Didn’t pay no reason given I think ins. Was max’d”. I learnt by accident that the second check was lost in the mail during one of my conversations with insurance agent. If Debbie had told me from the beginning, they would have got the second check much earlier instead of 4 months later on 11/21/05.
3. Debbie was not cooperative to resolve the dispute.
All Debbie wanted was that I pay the amount she made up on her own. I found out the discrepancy between two checks from my insurance company. I offered to pay the difference between the two checks, about $40. But Debbie refused to even give me this chance to pay my bill. She threatened: “You either pay the whole bill or this goes to collection”. From this, it is my understanding that she does not want negotiation. I do not have any chances to negotiate other dispute.
4. It is their own mistake if they feel that they did not get enough payment from insurance
One of Sylvia’s main jobs in the doctor’s office is to deal with insurance company. She checked with insurance company on my behalf, but she did not obtain a written estimate from my insurance company, she also failed to tell me to get a written estimate from my insurance company. This was the first surgery I ever had in my life. I should not be expected to be aware of such requirement while Sylvia should know about this requirement. She should obtain a written estimate on my behalf or tell me to obtain one. Now that this has become the excuse of my insurance company why they did not pay the full amount of their estimate, Sylvia should shoulder the responsibility.
5. The amount that is disputable at most is $363.84
Even though I do not think I should be responsible for the discrepancy of $363.84 between my insurance’s estimate and their actual payout, this is the amount that really can be discussed. I calculated this amount according to the following formula:
1474*80%-427.68-387.68=363.84
Note: 1474 is the amount of estimate, deducting 20% of my co-pay, meaning 1474*80% is the amount my insurance company should be responsible for if they stick to their estimate. 427.68, 363.68 are the two checks my insurance company actually paid out.
Since I am now far away from Little Rock, I am interested in settling this case: I would like to increase my offer from previous $40 (difference between two checks paid by my insurance company) to half of the disputable amount of $181.92 (363.84/2).
6. I have a very good credit history
Thanks to my relatively high education, I make a decent living and maintain a good credit record, I never owe any money to any body, I always pay my bill on time. If it is a reasonable bill, I will pay it without hesitation. I think the amount of money on this claim is not worth the trouble I suffered, but I have my principles, I would not overpay anybody who does not deserve to be paid. I believe in justice.
Counter Claim:
If they do not want to settle, then I would like to have my counter claim of $640. I spent at least 8 hours researching, writing up this letter. I also spent at least another 8 hours on researching, collecting facts, learning legal matters, seeking advices. I make about $40 per hour. Neglecting the hassle, discomfort, and anxiety I suffered throughout this legal process, I seek compensation for the hours I put on this legal matter. I pray this Court rule against plaintiff’s unfounded allegation, protecting average consumers like me, promoting an easy, fair, trustworthy commercial environment.
Sincerely,
longtermInvestor
Below is the brief story:
I had a dental procedure in Little Rock, AR on May, 2005. I am now living in Fremont, CA. The list price for my surgery is 1920. My insurance's estimate before surgery is 1474. I had negotiation with the dental office before the surgery. I made my copay of 365 before surgery. I do not remember how much is the total price now since at that time I only cared how much I need to pay.
Below is the letter I wrote to judge, please point out incorrect part.
11/20/2006
The Honorable
The Municipal Court of Pulaski County Arkansas Civil Division
3001 West Roosevelt
Little Rock, Arkansas 72204
Re: Dental Bill Dispute
Dear Honorable Judge:
I tried my best to write to you this letter to explain the situation. If there is anything here in this letter sounds informal, rude, or careless, please forgive me because that is not my intention. I am a foreigner in this country, although I try my best to master English and American culture, this is very hard for me.
Background: I had a dental insurance that has a $50 deductible and 20% co-pay when I had the dental procedure in dispute: Gingiv Flap Proc.
Summery:
• The price for my surgery is not $1920. That is list price. I never agreed to pay that price. They do not have any document signed by me showed that I agreed to pay that price. Going with the insurance estimate of $1474 before the surgery. I only need to pay $294.8 (20% co-pay). After negotiation, they told me I only need to pay $365 out of pocket, that I paid before the surgery.
• Debbie is the office lady of dental office who decided that I owe them money. Debbie does not know what really happened, she did not work for the dental office when I negotiated with Sylvia and had my surgery. Her words on this legal matter should not be relied on. By the way, Debbie does not work for this dental office anymore.
• There is a discrepancy between the estimate and actual payout from my insurance company. My insurance company’s excuse is that we did not have a written estimate. I think it is Sylvia’s responsibility to obtain a written estimate. She is a professional lady working on insurance claims on behalf of patients. She should know better than me.
• I have a very good credit history and a decent relatively high paying job. I have a master’s degree. Everything in my life suggests that I would honor my social agreement. The fact is that I do not owe anybody else any money.
Explanation:
1. The price of my dental bill ($1920) in the claim is the list price, not negotiated price.
I was given this price the first time I was told I need to have this procedure after I had x-ray on 4/21/05. I obtained the dental procedure code and got an estimate from my dental insurance on 4/27/05. The estimate was $1474. This transaction is on the insurance company’s record. I informed the estimate to Sylvia, the office lady in the dental office. I told Sylvia the list price is too high compared to insurance estimate. I was surprised at such a big discrepancy. Sylvia checked with my insurance company and negotiated with me. Finally she told me that $365 is all I need to pay. So I paid that amount before I had surgery. When I paid the bill before the surgery, I was pretty sure the price would be the last thing for me to worry about after several round of negotiation. So you can imagine how surprised I was when I got a call from Debbie asking for more money. I was even more surprised to see that the list price instead of negotiated price was there in the claim.
2. Debbie does not know anything about my negotiation with Sylvia but she asserted that I owe her money
Debbie was not there when I negotiated with Sylvia and had my surgery. Debbie was the lady who decided to forward my account to collection agency. I do not understand on what ground she reached her conclusion that I owe her money. Debbie does not know anything about this procedure, she does not even try. You can see it in the following evidence:
a) Debbie added an $85 charge for post surgery eval. Sylvia did not file claim about this charge with my insurance company. If there was such a charge, I am sure Sylvia would file a claim and I would have paid my co-pay during office visit. I made co-pay for my X-ray and surgery on the spot. I would have done the same thing if I think I owe them 85 bucks. I had never heard of such a charge before Debbie came into the picture. I had always talked with Sylvia about the price of the whole procedure. I would not want to be in a difficult situation that Dentist can add whatever charge he/she feels like.
b) From the beginning Debbie was talking about the list price. She was not aware of the negotiation happened between Sylvia and me. She denied the negotiation at the beginning. Then some day later, she suddenly told me she found that Sylvia had a discount for me written down in some book. You can see from the patient transactions that a discount of $206.5 was recorded on 8/2/05, about 3 months later than the surgery took place. If there was a discount, it should be recorded before or when the surgery took place. To be honest, I do not remember the exact discount number. All I cared about at that time was what out of pocket co-pay I would have to pay, which was $365.
c) At the beginning she did not even know the second check from my insurance company was lost in the mail. She did not even bother to check with insurance company and that is why she was not aware of the lost check. In the patient transactions in the legal document, it still says “Ins. Didn’t pay no reason given I think ins. Was max’d”. I learnt by accident that the second check was lost in the mail during one of my conversations with insurance agent. If Debbie had told me from the beginning, they would have got the second check much earlier instead of 4 months later on 11/21/05.
3. Debbie was not cooperative to resolve the dispute.
All Debbie wanted was that I pay the amount she made up on her own. I found out the discrepancy between two checks from my insurance company. I offered to pay the difference between the two checks, about $40. But Debbie refused to even give me this chance to pay my bill. She threatened: “You either pay the whole bill or this goes to collection”. From this, it is my understanding that she does not want negotiation. I do not have any chances to negotiate other dispute.
4. It is their own mistake if they feel that they did not get enough payment from insurance
One of Sylvia’s main jobs in the doctor’s office is to deal with insurance company. She checked with insurance company on my behalf, but she did not obtain a written estimate from my insurance company, she also failed to tell me to get a written estimate from my insurance company. This was the first surgery I ever had in my life. I should not be expected to be aware of such requirement while Sylvia should know about this requirement. She should obtain a written estimate on my behalf or tell me to obtain one. Now that this has become the excuse of my insurance company why they did not pay the full amount of their estimate, Sylvia should shoulder the responsibility.
5. The amount that is disputable at most is $363.84
Even though I do not think I should be responsible for the discrepancy of $363.84 between my insurance’s estimate and their actual payout, this is the amount that really can be discussed. I calculated this amount according to the following formula:
1474*80%-427.68-387.68=363.84
Note: 1474 is the amount of estimate, deducting 20% of my co-pay, meaning 1474*80% is the amount my insurance company should be responsible for if they stick to their estimate. 427.68, 363.68 are the two checks my insurance company actually paid out.
Since I am now far away from Little Rock, I am interested in settling this case: I would like to increase my offer from previous $40 (difference between two checks paid by my insurance company) to half of the disputable amount of $181.92 (363.84/2).
6. I have a very good credit history
Thanks to my relatively high education, I make a decent living and maintain a good credit record, I never owe any money to any body, I always pay my bill on time. If it is a reasonable bill, I will pay it without hesitation. I think the amount of money on this claim is not worth the trouble I suffered, but I have my principles, I would not overpay anybody who does not deserve to be paid. I believe in justice.
Counter Claim:
If they do not want to settle, then I would like to have my counter claim of $640. I spent at least 8 hours researching, writing up this letter. I also spent at least another 8 hours on researching, collecting facts, learning legal matters, seeking advices. I make about $40 per hour. Neglecting the hassle, discomfort, and anxiety I suffered throughout this legal process, I seek compensation for the hours I put on this legal matter. I pray this Court rule against plaintiff’s unfounded allegation, protecting average consumers like me, promoting an easy, fair, trustworthy commercial environment.
Sincerely,
longtermInvestor
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