NORTH OHIO HEART OHIO MEDICAL GROUPPartners for your health 2/19/15Revdex.com ID# [redacted] Upon reviewing the patient’s concern, North Ohio Heart pulled insurance explanation of benefits (EOB) from to present and compared the patient paid amount verses the co-pay amount listed from insurance.Patient payments matched the EOB until when Medical Mutual of Ohio, Ohio Public Employee Retirement System (OPERS) insurance plan made a change to their co-pay levelsOPERS went from PCP and Specialist co-pay amount to multiple co-pays depending on what the patient was being seen for by the physicianSee below a copy of an insurance card with the co-pays listed: See enclosed chartNorth Ohio Heart collects co—pays prior to the visit, therefore front office staff does not know what which diagnosis code the physician will use for the appointment, therefore unable to identify the exact co-pay that will need to be collected.As for diagnosis code, physician selects the code for which best supports his exam and findings, therefore supported in his documentationThis is a medically accepted process and insurance companies, including Medical Mutual of Ohio accepts the process.As for the overpayments made by the patient, she recently received a refund of $80.00.North Ohio Heart does not charge interest on outstanding balances; therefore it is not our policy to reimburse interest.The reason she did not receive a refund sooner, is due to our policy that if patient is scheduled for another visit within a set timeframe of a paid date of service, we hold the credit to ensure no balance is due on upcoming visitTo avoid future overpayrnents, we have noted the patient’s account to only collect the value co-pay amount and if insurance determines the higher amount is due, we will bill the patient
NORTH OHIO HEART OHIO MEDICAL GROUPPartners for your health 2/19/15Revdex.com ID# [redacted] Upon reviewing the patient’s concern, North Ohio Heart pulled insurance explanation of benefits (EOB) from to present and compared the patient paid amount verses the co-pay amount listed from insurance.Patient payments matched the EOB until when Medical Mutual of Ohio, Ohio Public Employee Retirement System (OPERS) insurance plan made a change to their co-pay levelsOPERS went from PCP and Specialist co-pay amount to multiple co-pays depending on what the patient was being seen for by the physicianSee below a copy of an insurance card with the co-pays listed: See enclosed chartNorth Ohio Heart collects co—pays prior to the visit, therefore front office staff does not know what which diagnosis code the physician will use for the appointment, therefore unable to identify the exact co-pay that will need to be collected.As for diagnosis code, physician selects the code for which best supports his exam and findings, therefore supported in his documentationThis is a medically accepted process and insurance companies, including Medical Mutual of Ohio accepts the process.As for the overpayments made by the patient, she recently received a refund of $80.00.North Ohio Heart does not charge interest on outstanding balances; therefore it is not our policy to reimburse interest.The reason she did not receive a refund sooner, is due to our policy that if patient is scheduled for another visit within a set timeframe of a paid date of service, we hold the credit to ensure no balance is due on upcoming visitTo avoid future overpayrnents, we have noted the patient’s account to only collect the value co-pay amount and if insurance determines the higher amount is due, we will bill the patient