The Raby Institute for Integrative Medicine at Northwestern

Initial Business Response / [redacted] (1000, 8, 2014/10/31) */ The patient was prescribed weeks of injections as she had notedThe patient stated we would check benefits for the injectionsThe practice does not check benefits for injections and therefore we would not know if her insurance covered them or not When injections are performed in the office, the MD does not bill an office visit with the codes used for the injectionThe only time a co-pay is required is when the doctor is having a visit with the patientSince this is not the case for an injection, a co-pay is not required The patient received injectionsOf these six injections, has been denied to date, has been paid by insurance and are still pending review by the insurance companyThe patient has only been billed for the one denied injection and she paid the balance for this injection on 9/26/The practice did provide the patient a 20% discount on this denied claimThe patient stated she is receiving bills for all six injectionsThis is incorrectThe last statement generated for the patient was on 9/26/and the patient paid the balanceThis statement reflected the paid claim and the denied claim referenced earlier Prior to seeing the providers, each patient is asked to review and sign a financial responsibility form which states that they are financially responsible for any charges that are not covered by insurancePatients are also encouraged to know the coverage of their medical plan as there are many different plans with different levels of coverageThis patient reviewed the financial responsibility form and signed it agreeing to pay for all services not covered by insurance As a general rule, we are consistently communicating to our patients that it is in their best interest to understand their insurance coverage and to call to be sure they understand what their insurance covers and does not coverUltimately it is the responsibility of the patient to know their insurance coverage The patient was contacted on 10/to discuss these items with no return of phone call Initial Consumer Rebuttal / [redacted] (3000, 10, 2014/11/07) */ (The consumer indicated he/she DID NOT accept the response from the business.) I was out of the country and that was why I was not able to return their phone callIt is that the practice says they do not check benefits for injections because their administrative assistant at the time specifically checked with the insurance company before booking the appointmentsShe called me back to let me know the insurance would not cover but that she was told to go ahead to book my appointments because I would only be charged for office visitsIt is irresponsible for the Raby Institute to not take responsibility for this miscommunication with their staff It is true that all six injections are denied by the insurance companyWhen I called the insurance company they told me the one injection that was approved was now denied and I would be receiving a bill for it

Initial Business Response /* (1000, 8, 2014/10/31) */
The patient was prescribed 6 weeks of injections as she had noted. The patient stated we would check benefits for the injections. The practice does not check benefits for injections and therefore we would not know if her insurance...

covered them or not.
When injections are performed in the office, the MD does not bill an office visit with the codes used for the injection. The only time a co-pay is required is when the doctor is having a visit with the patient. Since this is not the case for an injection, a co-pay is not required.
The patient received 6 injections. Of these six injections, 1 has been denied to date, 1 has been paid by insurance and 4 are still pending review by the insurance company. The patient has only been billed for the one denied injection and she paid the balance for this injection on 9/26/2014. The practice did provide the patient a 20% discount on this denied claim. The patient stated she is receiving bills for all six injections. This is incorrect. The last statement generated for the patient was on 9/26/2014 and the patient paid the balance. This statement reflected the paid claim and the denied claim referenced earlier.
Prior to seeing the providers, each patient is asked to review and sign a financial responsibility form which states that they are financially responsible for any charges that are not covered by insurance. Patients are also encouraged to know the coverage of their medical plan as there are many different plans with different levels of coverage. This patient reviewed the financial responsibility form and signed it agreeing to pay for all services not covered by insurance.
As a general rule, we are consistently communicating to our patients that it is in their best interest to understand their insurance coverage and to call to be sure they understand what their insurance covers and does not cover. Ultimately it is the responsibility of the patient to know their insurance coverage.
The patient was contacted on 10/2814 to discuss these items with no return of phone call.
Initial Consumer Rebuttal /* (3000, 10, 2014/11/07) */
(The consumer indicated he/she DID NOT accept the response from the business.)
I was out of the country and that was why I was not able to return their phone call. It is false that the practice says they do not check benefits for injections because their administrative assistant at the time specifically checked with the insurance company before booking the appointments. She called me back to let me know the insurance would not cover but that she was told to go ahead to book my appointments because I would only be charged for office visits. It is irresponsible for the Raby Institute to not take responsibility for this miscommunication with their staff.
It is true that all six injections are denied by the insurance company. When I called the insurance company they told me the one injection that was approved was now denied and I would be receiving a bill for it.