Beltone Hearing Center

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed Administratively Resolved] Complaint: [redacted] I am rejecting this response because: Regards, [redacted]

In Response To Complaint; The patient’s daughter had first contacted me regarding the insurance claim through [redacted] Insurance as stated “the 7th of November” She told me that [redacted] had no record of the claim, FROM APRILThis was the first time we had been notified (as the check goes directly to the patient) that a check was never received .The patient was also advised at the time of the sale, to “call us if the check does not arrive within weeks”I told the patient’s daughter that I would “resend the claim”, which is simply a letter to [redacted] asking to send the patient $800, as a credit for purchasing hearing aidsI feel the need to emphasize that the sale was in April, and the 7th of November was the first we had been notified that the check was not received This process generally takes about weeks total timeThe claim is mailed, then processed by [redacted] (which takes about weeks to be entered into their system), then about a week to process the checkI told the patient’s daughter that it is best for the patient to call the number on the back of the insurance card, and follow up on the claim I’ve personally had patients who have mailed [redacted] claim requests multiple times without a response from [redacted] , and it not uncommon to have to remail the letterI told the patient's daughter that I would call her when I was notified the CLAIM WAS RECIVED by [redacted] , about weeks I remailed the claim on the 8th, a day after I had initially heard from the daughter of the patient that the claim was never received from FebruaryPrior to that, I had not spoken with the daughter, nor had the patient herself ever contacted us As far as the complainant stating that “I was send her proof the claim was sent”, I would not, as all the claim is a letter to [redacted] with information that is HIPPA protectedThe patient may give any medical information she would like to her daughter, I may not per a signed HIPPA Claims take time, I was hoping to have a response from [redacted] by the time I responded to this claim, however, with the Thanksgiving holiday, it has only been about business days since the new claim was sent The patient’s daughter had not contacted me after we had spoken on the 7th, instead she contacted the Revdex.com, and I am unsure as to how to respond now

In Response To Complaint;
The patient’s daughter had first
contacted me regarding the insurance
claim through *** Insurance as stated “the 7th of November”
She told me that *** had no record of the claim, FROM APRILThis was the
first time we had been notified (as the check goes directly to the patient) that
a check was never received .The patient was also advised at the time of the
sale, to “call us if the check does not arrive within weeks”I told the patient’s
daughter that I would “resend the claim”, which is simply a letter to ***
asking to send the patient $800, as a credit for purchasing hearing aidsI
feel the need to emphasize that the sale was in April, and the 7th
of November was the first we had been notified that the check was not received
This process generally takes about
weeks total timeThe claim is mailed, then processed by *** (which takes
about weeks to be entered into their system), then about a week to process
the checkI told the patient’s daughter that it is best for the patient to
call the number on the back of the insurance card, and follow up on the claim
I’ve personally had patients who have mailed *** claim requests multiple
times without a response from ***, and it not uncommon to have to remail
the letterI told the patient's daughter that I would call her when I was notified the CLAIM WAS RECIVED by ***, about weeks
I remailed the claim on the 8th, a day after I
had initially heard from the daughter of the patient that the claim was never received
from FebruaryPrior to that, I had not spoken with the daughter, nor had the patient
herself ever contacted us
As far as the complainant stating that “I was send her proof
the claim was sent”, I would not, as all the claim is a letter to *** with information that is HIPPA protected. The patient may give any medical information she would like to her daughter, I may not per a signed HIPPA
Claims take time, I was hoping to have a response from ***
by the time I responded to this claim, however, with the Thanksgiving holiday,
it has only been about business days since the new claim was sent
The patient’s daughter had not contacted me after we had
spoken on the 7th, instead she contacted the Revdex.com, and I am unsure as
to how to respond now

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because:
Regards,
[redacted]

In Response To Complaint;
The patient’s daughter had first contacted me regarding the insurance
claim through [redacted] Insurance as stated “the 7th of November”.
She told me that [redacted] had no record of the claim, FROM APRIL. This was the
first time we had been notified (as the check...

goes directly to the patient) that
a check was never received .The patient was also advised at the time of the
sale, to “call us if the check does not arrive within 5 weeks”. I told the patient’s
daughter that I would “resend the claim”, which is simply a letter to [redacted]
asking to send the patient $800, as a credit for purchasing hearing aids. I
feel the need to emphasize that the sale was in April, and the 7th
of November was the first we had been notified that the check was not received.
This process generally takes about 4
weeks total time. The claim is mailed, then processed by [redacted] (which takes
about 3 weeks to be entered into their system), then about a week to process
the check. I told the patient’s daughter that it is best for the patient to
call the number on the back of the insurance card, and follow up on the claim.
I’ve personally had patients who have mailed [redacted] claim requests multiple
times without a response from [redacted], and it not uncommon to have to remail
the letter. I told the patient's daughter that I would call her when I was notified the CLAIM WAS RECIVED by [redacted], about 2 weeks.
I remailed the claim on the 8th, a day after I
had initially heard from the daughter of the patient that the claim was never received
from February. Prior to that, I had not spoken with the daughter, nor had the patient
herself ever contacted us.
As far as the complainant stating that “I was send her proof
the claim was sent”, I would not, as all the claim is a letter to [redacted] with information that is HIPPA protected. The patient may give any medical information she would like to her daughter, I may not per a signed HIPPA.
Claims take time, I was hoping to have a response from [redacted]
by the time I responded to this claim, however, with the Thanksgiving holiday,
it has only been about 12 business days since the new claim was sent.
The patient’s daughter had not contacted me after we had
spoken on the 7th, instead she contacted the Revdex.com, and I am unsure as
to how to respond now.