WESTMED Medical Group

Review: On 11/**/14 I had a yearly dermotologial exam. The Doctor removed a tiny blackhead from my week on the right side of my face. She did not inform me that this was considered "surgery" nor did she inform me that I was going to be billed $300.Desired Settlement: an adjustment of the charge as this was "surgery"

Review: I am being billed for $155.00 for my appointment with [redacted] at WESTMED Medical Group. When I booked this appointment,I wanted a checkup and to ask about hair laser removal. I was told that I had to book two separate appointments. Before making the appointment, I asked if my insurance would be accepted as payment in full for the consultation and the checkup and was told that it would be. I had the consultation with [redacted] who informed me that the onsite laser equipment was out-dated and could not be used for persons of color. He referred me to an office in Manhattan for the treatment. I paid the co-pay. Some weeks later I received an invoice for $155.00. I called the office and was informed that the claim had not been submitted to GHI. Some weeks later I received another bill for $155.00. Since then I have contacted the billing office several times to resolve this issue but to no avail. I was told by one representative tell me that even if misinformation was given to me by their front desk, it is not their fault. I also reached out to GHI which upon investigating found out that the code used to submit the claim was non-existent. GHI stated that they had processed several claims from [redacted] at WESTMED for the same consultation for other patients and had paid the claims. GHI requested that WESTMED reach out to them for assistance.I tried to contact [redacted] directly but was told that he could not speak with me. Last month (6/**/14) I contacted [redacted] at WESTMED customer relations and explained my situation. He took down all my information, said he would look into and get right back to me but he did not. Today I called [redacted] again. He did not remember me and apologized for not calling me back. He informed me that since [redacted] had the consultation with me, he deserves to be paid in full regardless of the fact that he could not perform the procedure. He also stated the the fee of $155.00 was the lowest on the pay scale and that a payment plan can be worked out for me to pay it.Desired Settlement: I would like for Billing Department at the WESTMED Medical Group to reach out to GHI for the correct claim code needed to process the claim. Send the claim in, and to accept the amount that GHI pays as payment-in-full for the visit.

Business

Response:

We would welcome the opportunity to respond in detail to the complaint filed with your office. However, due to the federal Health Insurance Accountability and Portability Act (HIPAA) regarding patient privacy, we are constrained from doing so. But we are happy to communicate directly with the complainant in an attempt to address the concerns raised. Thank you

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:

I have not been contacted by WestMed as requested nor has GHI. I am very open to resolving this matter in a timely fashion.

Thank you for your attention to this matter.

In order for the Revdex.com to appropriately process your response, you MUST answer the question above.

Sincerely,

Business

Response:

We would welcome the opportunity to respond in detail to the complaint filed with your office. However, due to the federal Health Insurance Accountability and Portability Act (HIPAA) regarding patient privacy, we are constrained from doing so. But we are happy to communicate directly with the complainant in an attempt to address the concerns raised. Thank you.

The HIPPA Form is attached. Please complete and return to [redacted]