PAML

I am sorry that Mr [redacted] does not accept our response Let me reiterate what I stated in my initial response which I believe provides the documentation that he is demanding now: The reasaon why the initial amount due was higher than the eventual EOB that was recieved from Premera is that Premera instructed us to bill that initial amount to the guarantor They then reprocessed the claim based on the chart notes that we were required to submit from the ordering provider which resulted in a lower patient responsibility Our standard process is to send billing statements over a month period of time with the final statement marked "delinquent" whihc simply indicates it is "past due" In the case of the account there were a total of billing statements sent since the date of service of 9/10/ The process that is used to send the "delinguent" letter is totally automated based on length of time the bill was outstanding and so there is no way that this automated process could be aware of this Revdex.com complaint In addiiton, I am not in the billing department and so have no connection to this automated process To make an allegation of retaliation is unwarranted This account is now resolved entirely and there has never been an allegation of wrong doing on the part of the guarantor, Mr [redacted] There could be no impact to Mr [redacted] 's credit score as we do not report anything to any credit bureau unless we turn an account over to an outside collection agency which we did not do with this account Mr [redacted] can confirm that himself with the credit agencies.We consider this complaint successfully resolved

[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] Revdex.com, I have reviewed the response made by the business in reference to complaint ID [redacted] and have determined that this does not resolve my complaintFor your reference, details of the offer I reviewed appear below While I appreciate that the business is going to refund me my overpayment, I still am dissatisfied (for lack of a stronger word) with the business' response and the fact that I was charged for am amount that exceeded the EOB assessed amountAlso, it should be noted that the business in the meantime went ahead and marked my account as delinquent! I have to assume that this is a retaliatory action taken against me as a result of my Revdex.com complaint as I received a letter stating this in the mail yesterday, causing me additional frustration with this business that clearly is trying to squeeze as much money from me as they can, while doing as much damage to me as they can get away withI wish to escalate this with Revdex.com, and now demand that the business produces proof that not only a) am I in good standing regarding my account, b) but furthermore produce in writing THAT I DID NOTHING WRONG in this entire unfortunate affair, and c) provide proof that the fact that they marked my account as delinquent has no consequence to my credit scoreIf any of these demands are not satisfied, I am determined to escalate this matter further also with the HR department of my employer (Microsoft), and the health professionals me and my family are seeing to make sure to inform them about these very questionable business practices Regards, [redacted]

The charges for the tesing performed on Ms [redacted] for lab testing on 4/15/were billed appropriately to her insurance, Tricare with the diagnosis information supplied by the ordering provider which was *** This ICD-code is a general code and not specific to a diagnosis or signs and symptoms for that patient for that date of service and that code is statuatorily not covered by Tricare and is denied and so would be the patient's responsiblity to pay We did bill appropriately based on the information we were given.In August the office of the ordering provider contacted us and was able to supply additional more specific ICD-codes which have since been submitted to Tricare Ms [redacted] 's claim is being processed by Tricare at this time We have put the account on hold pending the response from Tricare on coverage

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution is satisfactory to meI would like to pay $today by credit card to satisfy this account in full Please call at your earliest convenience Sincerely, [redacted] ***

One of PAML's Customer Service Billing Coordinator's has spent time talking with Ms [redacted] and working to investigate what happened with the HSA billing issues As of May Ms [redacted] is now satisfied that the situation has been resolved We are working in our billing department to revisit the HSA payment posting procedures so that we are consistently handling them accurately These payments can be challenging and take longer depending on where the payment was initially sent which, in this case, was to the hospital which in turn cashed the check and then sent payment to us In addition, we are also retraining staff in communication protocols so that issues for which they do not have a ready and correct response will be escalated to a supervisor or manager in a timely manner

I am sorry that Mr*** does not accept our response. Let me reiterate what I stated in my initial response which I believe provides the documentation that he is demanding now:1. The reasaon why the initial amount due was higher than the eventual EOB that was recieved from Premera is that Premera instructed us to bill that initial amount to the guarantor. They then reprocessed the claim based on the chart notes that we were required to submit from the ordering provider which resulted in a lower patient responsibility.2. Our standard process is to send billing statements over a month period of time with the final statement marked "delinquent" whihc simply indicates it is "past due". In the case of the account there were a total of billing statements sent since the date of service of 9/10/2014.3. The process that is used to send the "delinguent" letter is totally automated based on length of time the bill was outstanding and so there is no way that this automated process could be aware of this Revdex.com complaint. In addiiton, I am not in the billing department and so have no connection to this automated process. To make an allegation of retaliation is unwarranted.4. This account is now resolved entirely and there has never been an allegation of wrong doing on the part of the guarantor, Mr***.5. There could be no impact to Mr***'s credit score as we do not report anything to any credit bureau unless we turn an account over to an outside collection agency which we did not do with this account. Mr*** can confirm that himself with the credit agencies.We consider this complaint successfully resolved

After investigation we found that the billing statement states that the payment is due within days. The patient missed that deadline (at least twice).If the patient had made a payment within the timeframe after receiving the 11/statement then the 12/statement would have been a rebill
instead of a final notice. The final statement actually says "final statement" with a note that the accounts will be referred to a collection agency if not paid. We have pulled this account from the collection agency and put it on hold so that Mr*** can arrange to make the last two payments as part of the payment plan

In investigting this situation I learned that initially the patient's insurance carrier - Premera - did not proceess the claim completely but rather asked for chart notes from the ordering provider's office to substantiate/clarify the test orders. After we were able to obtain those chart notes
we submitted them to Premera as directed. After they had completed their processing they sent a new EOB to us which stated that the patient was responsible for only $of the initial claim which had been for a total of $1728. We had accepted - per our contract with Premera - the contractual allowance of $for all testing that date of service.A payment of $was made by the patient's parents on 6/19/which exceeded the final amount due according to the EOB received by the lab from Premera.Actions taken:The $will be refunded by check to Mr***.The $balance due has been written off and so at this time there is no balance due for this account. We apologize for the length of time it took the iinsurance company and the lab to resolve this claim.We are unable to reimburse for time spent in resolving this claim

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me
Sincerely,
*** ***I disagree with the response from PAC Lab that my payment was late in NovemberNovember payment was not even in the original discussionI will contact PAC Lab and set up a payment plan like I did the first timeI will also inform my doctor that any future tests performed on my family are NOT to be sent to PAC Lac for any reason due to they're unfair billing practices

I apologize for the delay in responding to this complaint but we were not given the actual patient's name in the complaint so needed further research to make sure we were dealing with the correct patient. The standard process for sending billing statements to patients is to wait to send
the first statement until we have heard back from the patient's insurance as to whether they will cover the claim or not. So the first billing statement went to Mr*** on 11/24/2016. We have pulled the EOBs from the UMR website to verify that our lab was 'in network" which it was but the claim was denied as not being a covered benefit under their insurance plan. In other words, the services that Mr*** had done were an exclusion to that policy regardless of the testing lab.Due to this exclusion we can offer a 40% discount on the account which would leave a balance due of $451,but that comes with a requirement that this amount would need to be paid in full at the time the discount offer was accepted. If, instead, the patient would like to establish a payment plan for the full amount he can contact the billing office to set up that payment plan

[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]
Revdex.com,
I have reviewed the response made by the business in reference to complaint ID *** and have determined that this does not resolve my complaintFor your reference, details of the offer I reviewed appear below
While I appreciate that the business is going to refund me my overpayment, I still am dissatisfied (for lack of a stronger word) with the business' response and the fact that I was charged for am amount that exceeded the EOB assessed amountAlso, it should be noted that the business in the meantime went ahead and marked my account as delinquent! I have to assume that this is a retaliatory action taken against me as a result of my Revdex.com complaint as I received a letter stating this in the mail yesterday, causing me additional frustration with this business that clearly is trying to squeeze as much money from me as they can, while doing as much damage to me as they can get away withI wish to escalate this with Revdex.com, and now demand that the business produces proof that not only a) am I in good standing regarding my account, b) but furthermore produce in writing THAT I DID NOTHING WRONG in this entire unfortunate affair, and c) provide proof that the fact that they marked my account as delinquent has no consequence to my credit scoreIf any of these demands are not satisfied, I am determined to escalate this matter further also with the HR department of my employer (Microsoft), and the health professionals me and my family are seeing to make sure to inform them about these very questionable business practices
Regards,
*** ***

The charges for the tesing performed on Ms. [redacted] for lab testing on 4/15/2015 were billed appropriately to her insurance, Tricare with the diagnosis information supplied by the ordering provider which was [redacted].  This ICD-9 code is a general code and not specific to a diagnosis or signs and...

symptoms for that patient for that date of service and that code is statuatorily not covered by Tricare and is denied and so would be the patient's responsiblity to pay.  We did bill appropriately based on the information we were given.In August the office of the ordering provider contacted us and was able to supply additional more specific ICD-9 codes which have since been submitted to Tricare.  Ms. [redacted]'s claim is being processed by Tricare at this time.  We have put the account on hold pending the response from Tricare on coverage.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. I would like to pay $451.14 today by credit card to satisfy this account in full.  Please call at your earliest convenience.
Sincerely,
[redacted]

[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]
Revdex.com,
I have reviewed the response made by the business in reference to complaint ID [redacted] and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Regards,
[redacted]

I apologize for the delay in responding but we can find no record of any laboratory testing or billing done for patient [redacted] at any time in 2016 let alone the date of service in the complaint.  If, in fact, Ms. [redacted] is submitting her complaint for a different patient then we would...

need that person's full name and any other identifiers like DOB so we can research the complaint for the appropriate patient.

One of PAML's Customer Service Billing Coordinator's has spent time talking with Ms. [redacted] and working to investigate what happened with the HSA billing issues.  As of May 25 Ms. [redacted] is now satisfied that the situation has been resolved.  We are working in our billing department to...

revisit the HSA payment posting procedures so that we are consistently handling them accurately.  These payments can be challenging and take longer depending on where the payment was initially sent which, in this case, was to the hospital which in turn cashed the check and then sent payment to us.  In addition, we are also retraining staff in communication protocols so that issues for which they do not have a ready and correct response will be escalated to a supervisor or manager in a timely manner.

I apologize for the delay in responding to this complaint but we were not given the patient's name or any other identifying information such as date of birth, but only the father's name so the search for account information took longer than usual.   We believe that the patient in...

question is [redacted].  On the test requeset paperwork for the testing on4/15/2014 there was no billing/insurance information, no address, no guarantor name.  Without any of these details the billing department looked in historical files and there were no addresses on any previous dates of service.  The initial account for this patient was created in 2002 but we could only access details from 2004 to the present, but again, no addresses were provided but past accounts appeared to go back and forth between the Post Office Box and the street address a few times. We only sent 2 statemetns out for this date of service on 6/20/2014 and 9/11/2014, both to POB 342 Colbert.  Both were returned as undeliverable so no other statements were sent to that address.  We attempted to obtain a more current/accurate address from the ordering physician but did  not recieve any additional information back.  We did try to bill Molina insurance but learned that the patient was not eligible on that date of service.  The account aged to collections on 10/31/2014 but we did not hear from the father until he called on 9/4/2015 and gave us the correct street address in Colbert.  A statement was then sent to him through the collection agency so he could bill his insurance.  At this time the account is with the collection agency and the parents need to work with that agency to resolve this account.

Our experience for our 9 month old son weight 20 pounds was horrendous. The staff at the front was friendly checking us in. The problem was the Phlebotomist. Two Phlebotomist helped us.

At the beginning they had me sit I in the chair holding my son and the second Phlebotomist held his arm. I was told by the pediatrician our son would get a heel or finger stick. I asked are you doing a heel stick ? He said no he is too old. I said at 9 months? And 20 pounds? He said yeah I can't do heel stick. I asked can you do a finger stick? He said no the skin to bone is too thin. I have to draw from a vein I need more blood.

This was a lie. The capillary stick would be plenty of blood. My son needed a CBC for his 9 month check up.

So as the Phlebotomist said we had no option. One phlebotomist held our sons arm straight to draw from his vein. My son was wailing once the tourniquet was tied. The other Phlebotomist a male drew with a butterfly digging once he inserted the needle in the elbow median vein -after palpating he cleaned, then palpated again and cleaned. Also not allowing the second alcohol swipe to dry. The skin was visible wet during the draw causing undue pain. Then phlebotomist said he was confident he could draw. Once the procedure was over he drew 5.5 ml.

The Phlebotomist should not have dug around. Or refused to let us leave. I said I didn't want an arm draw once my son was wailing with the tourniquet. The Phlebotomist said we are already here. Insinuating we can't leave and the second Phlebotomist wouldn't let go of my son's arm this was incredibly traumatic for my son. Taking him out of the pac lab and the whole business building he was crying tears streaming down his face it took 15 minutes in the car to calm down.

I am infuriated the staff traumatized my son by forcing us to stay. Taking too much blood. And prodding for the vein.

I hope to have an apology for this happening and assurance the Phlebotomist will be retrained proper technique and patient care rights.

Disturbing is I Know proper technique.

I just got my license as a Washington State Phlebotomy program.

http://www.bd.com/vacutainer/labnotes/Volume20Number1/

https://www.childrenscolorado.org/doctors-and-departments/departments/tests/lab-...⇄

Review: I AM BEING BILLED FOR A LAB SERVICE THAT IS NOT PATIENT RESPOSIBILITY. I HAVE CALLED SEVERAL TIMES AND PACLAB WANTS ME TO GET CORRECT BILLING CODES FOR THEM TO RESUBMIT TO INSURANCE. MY DOCTORS OFFICE AND MY INSURANCE CARRIER HAVE TOLD ME THIS IS NOT MY RESPONSIBILITY AND NOT MY BILL. THIS LAST CALL I GAVE THEM THE DOCTORS OFFICE PHONE NUMBER FOR THEM TO FOLLOW UP AND CLEAR THIS MATTER- SHE SAID IT WOULD BE PUT ON A LIST AND THEY WOULD GET TO IT WHEN THEY GET TO IT. SHE ALSO TOLD ME HIPA ACT DOES NOT ALLOW THEM TO ASK FOR THESE CODES.Desired Settlement: I WANT AN UPDATED STATEMENT SHOWING ZERO DOLLARS OWED.

Business

Response:

The charges for the tesing performed on Ms. [redacted] for lab testing on 4/15/2015 were billed appropriately to her insurance, Tricare with the diagnosis information supplied by the ordering provider which was [redacted]. This ICD-9 code is a general code and not specific to a diagnosis or signs and symptoms for that patient for that date of service and that code is statuatorily not covered by Tricare and is denied and so would be the patient's responsiblity to pay. We did bill appropriately based on the information we were given.In August the office of the ordering provider contacted us and was able to supply additional more specific ICD-9 codes which have since been submitted to Tricare. Ms. [redacted]'s claim is being processed by Tricare at this time. We have put the account on hold pending the response from Tricare on coverage.

Review: On April, 2014 Lab work was done by PAML which was ordered by a local doctor for my thirteen year old son. We the parents went to PAML to pick up the vials to provide samples to take back to PAML, which we did. Therefore we talked directly to PAML twice in a 24 hour period giving them information on my son and also ourselves. So once this was all established it was billed to our insurance company so we did not receive any bill. Come to find out our insurance did not cover the lab work, so PAML Proceeded to send a bill to our thirteen year old son which they did not have a address for so they came up with an old p.o. box # that was used by the family some 6 or 7 years ago knowing that they had the current address on file. Therefore they kept sending bills that would get returned back to them, so they sent my thirteen year old son to collections, not bothering to try to determine if they billed the right address or not. When I got the first letter from collections I called to find out the issue and explain ton them they had the wrong address, and they have been billing us for the last 6 years at our current address, that did not seem to matter to them and proceeded to follow through with collections.Desired Settlement: Talk with me and fix the issue.

Business

Response:

I apologize for the delay in responding to this complaint but we were not given the patient's name or any other identifying information such as date of birth, but only the father's name so the search for account information took longer than usual. We believe that the patient in question is [redacted]. On the test requeset paperwork for the testing on4/15/2014 there was no billing/insurance information, no address, no guarantor name. Without any of these details the billing department looked in historical files and there were no addresses on any previous dates of service. The initial account for this patient was created in 2002 but we could only access details from 2004 to the present, but again, no addresses were provided but past accounts appeared to go back and forth between the Post Office Box and the street address a few times. We only sent 2 statemetns out for this date of service on 6/20/2014 and 9/11/2014, both to POB 342 Colbert. Both were returned as undeliverable so no other statements were sent to that address. We attempted to obtain a more current/accurate address from the ordering physician but did not recieve any additional information back. We did try to bill Molina insurance but learned that the patient was not eligible on that date of service. The account aged to collections on 10/31/2014 but we did not hear from the father until he called on 9/4/2015 and gave us the correct street address in Colbert. A statement was then sent to him through the collection agency so he could bill his insurance. At this time the account is with the collection agency and the parents need to work with that agency to resolve this account.

Consumer

Response:

[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]

Revdex.com,

I have reviewed the response made by the business in reference to complaint ID [redacted] and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.

[To assist us in bringing this matter to a close, we would like to know your view on the matter.]

Regards,