8-2-Urgent Care

May 1, 2015,Patient Name: [redacted] ***Patient DOB: 12/06/1952Health Plan: [redacted] Date of Service: 01/24/2015Re: Complaint10: [redacted] Dear [redacted] ,This letter serves as our formal response to the complaint filed by [redacted] fiD [redacted] )want to thank: you for forwarding me this compraint and allowing us to respond tothis issueI have read the complaint and besides the fact that we have done nothing wrong,this is between the patient and her insurance carrier [redacted] .We rendered services for the patient on January 24, and the patient went throughher [redacted] InsuranceOn February 12th, 2015, we received the Explanation of Benefits (EOB}from [redacted] attributing $towards the patient's deductible [redacted] for some yearsnow, has set a deductible, which their patients have to meet prior to covering at 80%Thisdeductible is not set from us, it is set by [redacted] We are told, via the EOB, to collect thedeductibleThe patient was sent her balance by [redacted] in February as wellOn March 04,2015, we sent out a statement from our facility to the patientjust in case she did not receive [redacted] 's EOBOn March our AR staff member called the patient to check thestatus of the balance and to remind the patient of her responsibilityIt was during this phonecall that the patient { [redacted] ***) began to yell at my staff member and claimed she wouldnot pay the balanceThe patient began arguing about us overcharging her and [redacted] and began being abusive over the phoneMy staff member, simply reported the balance asit was past due and noted a late fee will apply if not paid in a timely manner (We documentall calls)On April, QJrd, 2015, we sent out another statement, this time with a rate fee addedto the statementOn April 13th, 2015, - April 20th, 2015, we tried to reach the patient once moreMay 03:35p Urgent Care 760-216-p.3with no successOur final attempt was made on April 30th, and the patient picked up thephone and once she knew it was my AR staff member, the patient hung up the phone[redacted] paid me $total for this date of service and the balance was attributedto patient responsibilityThis claim's balance was originally sent out on February by [redacted] .This claim is over days lateIf there is an issue with the deductible, this is between the patientand [redacted] This has nothing to do with us; we rendered excellent medical care and as aconsequence, we have not been paid.To summarize, we have received $payment from the insurance onlyWe did notbill improperly but instead as con1ractually obligatedThis issue comes down to the patient'sdeductible, which is between her and her insurance carrierLastly, we did try to contact thepatient to explain to her what had transpired and she hung up my AR Staff Member.If you have any additional questions, please don't hesitate to contact me at the numberlisted belowI would like to formally ask you to dismiss this case as we have done nothingremotely wrong.Yours in health, [redacted] Administrative ManagerOceanside BlvdSuite 09Oceanside, CA 92056P: 760-216-6253F: 60-6-