Send to Collection?

[Guest guest]

Hi all,  After opening my door for more than a year, I have one patient I would send to collection. I appreciate if you can give me advice.  A new patient came in one late afternoon with two invalid insurance cards but no ID. After we insist, he went to his car and brought  his passport. My assistant must be busy and didn't pay attention to our Phreesia check in pad alert on invalid insurances. The patient requested HTN meds refill and Narcotic Rx of #360 tablets because he was going abroad next day, and of course, he switched PCP... I tried to log into CURES, the California Prescription Drug Monitoring Program, but my password didn't work at that time. CURES has very strict rules about password, it just didn't work sometimes. I called them then realized because of the recent budget cut, the state dept no longer had a live person answering calls. In general, I have a policy of no Narcotic Rx on first visit. I kew there were so many red flags I should stay with my instincts. But When a morbid obese patient of 350 + lb complains of Low back pain, I believed him and wrote a much smaller amout of Narcotics as well as his BP meds. Later on I was able to log into CURES and found out he has been a doctor shopper. There were so many doctors ( license #s ) have been given him large amount of narcotics, like #360 tablets of Norco in 10 days. No one can consume that much Narcotic. So I reported him for suspicious activity, hoping someone can do something to stop him going to different doctors for controlled medications. By the time I called the Pharmacy, the meds were dispensed and pharmacy didn't have his ID because he paid cash. So some of the drug seeking acitivities must have not be recorded.

 A balance statement was sent to him a few weeks ago from my billing software. Today I got his response that he had file bankruptcy and " don't contact me anymore " . He wrote his case#. What a drama! Someone on the list said in the past primary care is more dramatic than a TV soap. I can't agree more. I don't feel too bad about the loss. But I do feel a little bit stupid that I was used and manipulated, after recognizing so many red flags. Now I am working on discharging him from my practice formally.

 My question is, could I send him to collection? And if one has filed bankruptcy, would collection make any difference to him or to me?  Thank you for your advice and experience.

Wen San Mateo, CA