Privy Oasis, LLC

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , they returned my moneyTheir response Included a lots of hogs wash but overall AC doThanks tobB Regards, [redacted]

APrivy Oasis Timely Submission of Claims & Unmet Deductible. As shown below and in the attached exhibits, contrary to complainant’s baseless allegations, Privy Oasis timely submitted claims to both, Medicare, the patient’s primary insurer, and Medicaid, the patient’s secondary
insurer, and reimbursed that patient upon receipt of payment from patient’s insurer for services rendered. On Thursday, July 6, at 12:pm, Complainant brought his daughter, the patient, to Privy Oasis, LLC for service. The father advised, over the phone, that the patient had Medicare insurance and, in person, that the patient also had Medicaid insurance. Privy Oasis personnel verified insurance with Medicare and Medicaid on July 6, and July 7, respectively. The Medicare representative informed Privy Oasis that since, as of that date, Medicare records indicated that the patient had not yet met the required $deductible for services, the patient would have to pay Privy Oasis that fee before Medicare would began paying for claimsSee EXHIBIT 1. The Medicaid representative informed Privy Oasis personnel that because it is the secondary insurer and the patient does not have a qualifying in-network plan, Medicaid would only pay any amounts that remained unpaid after patient met Medicare’s deductible and Medicare paid covered claimsSee EXHIBIT 2. Privy Oasis notified the complainant of this and advised that it would submit the claims to Medicare but warned that the claims process can take a while. Notwithstanding the lengthy process time, Privy Oasis explained to complainant that it would reimburse the patient if and when Medicare remitted payment to Privy Oasis for the services rendered. Privy Oasis submitted and resubmitted the July 6th claim to Medicare but both submissions were denied payment. When Medicare denied the claim for the second time, the patient became fully responsible for the amount that was billed. BComplainant Reimbursed After Medicare Paid for Claim. Privy Oasis resubmitted the claim to Medicare for the third time on August 31, 2017. This time, Medicare notified Privy Oasis that it would remit payment to Privy Oasis for services Privy Oasis rendered to the patient on July 6, The Medicare representative explained that that the patient met deductible with prior hospital visit(s) and medical treatment that were not yet reflected in Medicare’s system at the time Privy Oasis originally inquired and submitted claims to MedicareAccordingly, on September 19, 2017, Privy Oasis received payment from Medicare in the amount of $170.39. Once the payment cleared, Privy Oasis emailed the patient complainant the following: As previously explained the claims process can take some timeOn September 19, 2017, Privy Oasis, LLC received payment from Medicare in the amount of $for services rendered to you on July 6, Today, we billed your Secondary Insurance Medicaid for the remaining balance. Since we fully expect to be paid in full by your insured we are reimbursing your HRSA card in the amount of We will call you today in-order to get your card information to initiate the refund process. On September 25, 2017, Privy Oasis representative spoke with *** ***, obtained the necessary HRSA information, and refunded the patient’s HRSA card $and the $convenience fee for payment processingSee EXHIBIT 3. That same day, Privy Oasis submitted a claim for the difference due to complainant’s secondary insurer. CPrivy Oasis is Not Responsible for Payments to Third-Party Providers. Privy Oasis is not responsible for payments the patient may have paid to other, non-Privy Oasis, medical providers. Accordingly, Privy Oasis will not pay patient for medical fees patient incurred as a result of services it sought and received from third party providers. To obtain payments, refunds and/or reimbursements from such third party medical providers, the patient must speak directly with Medicare, Medicaid, or that third party medical provider. II. CONCLUSION Given the foregoing reasons and the attached exhibits, Privy Oasis urges the Revdex.com to review the attached exhibits and dismiss complainant’s claims in their entirety. Should you have any questions and/or comments regarding the foregoing statement or the attached exhibits, please feel free to contact me at your convenience. *** *** ***Privy Oasis, LLCChief Executive Officer

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], they returned my money. Their response Included a lots of hogs wash.  but overall AC do. Thanks to. bB
Regards,
[redacted]