To Whom it may concern:The office has been contacted and the practice manager has indicated DrD [redacted] will fill out the prior authorization form to the best of her abilityThe patient may be required to try other medications before approving the Viagra depending on his insuranceThis patient will also be referred to a Urologist so he can get specialized care for this issueThe office is contacting the patient to communication this information
Adena Health System is sorry to hear of this misunderstanding. When a patient goes to the Emergency Department, they may receive bills for multiple services depending on the care provided These will include a charge from the hospital for the use of the facility, supplies, testing,... staffing, etc. (billed by Adena), and a professional charge from the provider who performs the medical exam and sometimes treatments (billed by [redacted] ). Other bills related to specific services may be also received. These may include bills from a radiologist for interpreting any radiological tests, a pathologist for reading any pathology biopsies, an anesthesiologist for anesthesia administration, or charges for other specialty services. Adena Health System does not charge, send the billing, or negotiate for all these entities. [redacted] is the company that employs and managers the providers (physicians, physician assistants, and certified nurse practitioners) in the Emergency Department. Adena is not involved in their billing process. This billing process is common with other hospitals that use a vendor to employee physicians and bill for physician services in Emergency Department . However, it is our understanding that if a patient has applied and been approved for financial assistance, [redacted] takes this into consideration. We recommend that you contact [redacted] for assistance with their billing and ask about its financial assistance program . Another possible option is to fill out and apply for Adena Financial assistance and if you are offered assistance with Adena you can use and have proof for your bill [redacted] and it may get discounted by their discretion. Thank you for allowing us to investigate this concern.
I reviewed the response made by the business in reference to complaint ID ***, and find the resolution is satisfactory to meThis puts me back at square one*** is who I set up the payment plan for dollars a monthThey said it was perfectly fine and to make sure I paid all the payments on timeAnd everything was great for monthsAnd then adena calls me saying I have to pay a month with no incomeI've already set up a billing program through ***Thank you very muchI hope everything is resolved nowI had to pay different doctor bills and all the doctor done was give me a wrap for my hand and a ice packHe never looked or even felt my hand, and it's been about months since it happened and my hand is still the same from the day I went to the hospitalI'll pay the agreed amount of dollars a month as agreed with from *** months ago
Adena Health System is sorry to hear of this misunderstanding. When a patient goes to the Emergency Department, they may receive bills for multiple services depending on the care provided These will include a charge from the hospital for the use of the facility, supplies, testing,...
staffing, etc. (billed by Adena), and a professional charge from the provider who performs the medical exam and sometimes treatments (billed by [redacted]). Other bills related to specific services may be also received. These may include bills from a radiologist for interpreting any radiological tests, a pathologist for reading any pathology biopsies, an anesthesiologist for anesthesia administration, or charges for other specialty services. Adena Health System does not charge, send the billing, or negotiate for all these entities. [redacted] is the company that employs and managers the providers (physicians, physician assistants, and certified nurse practitioners) in the Emergency Department. Adena is not involved in their billing process. This billing process is common with other hospitals that use a vendor to employee physicians and bill for physician services in Emergency Department . However, it is our understanding that if a patient has applied and been approved for financial assistance, [redacted] takes this into consideration. We recommend that you contact [redacted] for assistance with their billing and ask about its financial assistance program . Another possible option is to fill out and apply for Adena Financial assistance and if you are offered assistance with Adena you can use and have proof for your bill [redacted] and it may get discounted by their discretion.
Thank you for allowing us to investigate this concern.
Below is the communication between the Patient Advocate office and the practice manager for Dr. D[redacted]' practice:
We
are definitely a patient advocate. We are happy to do prior
authorizations when they are required. The medication in question is Viagra.
Dr
D[redacted] is happy to...
prescribe the medication, however it is the patient’s
insurance company that is refusing to pay for the medication. We have
attempted on several occasions to get this type of medication prior authorized
for several patients and every insurance refuses to cover it- using their terminology
“it is not medically necessary”.
Per
Dr D[redacted], 100% of her patients who receive this type of prescription are
informed when she initially prescribes it that insurances very rarely cover
this and that it is out of pocket for the patient.
To Whom it may concern:The office has been contacted and the practice manager has indicated Dr. D[redacted] will fill out the prior authorization form to the best of her ability. The patient may be required to try other medications before approving the Viagra depending on his insurance. This patient will also be referred to a Urologist so he can get specialized care for this issue. The office is contacting the patient to communication this information.
But, as of 04/18/2016 the "prior authorization" is still waiting to be signed and returned to my prescription insurer. And the receptionist, Donna, told me over the phone "...they do not do prior authorizations per policy...". I would be fine with the decision being made by my prescription insurance company BUT Dr. D[redacted] has not returned the prior authorization. I just ask that Dr. D[redacted] sign and return the "prior authorization"....
To Whom it may concern:The office has been contacted and the practice manager has indicated DrD [redacted] will fill out the prior authorization form to the best of her abilityThe patient may be required to try other medications before approving the Viagra depending on his insuranceThis patient will also be referred to a Urologist so he can get specialized care for this issueThe office is contacting the patient to communication this information
Adena Health System is sorry to hear of this misunderstanding. When a patient goes to the Emergency Department, they may receive bills for multiple services depending on the care provided These will include a charge from the hospital for the use of the facility, supplies, testing,... staffing, etc. (billed by Adena), and a professional charge from the provider who performs the medical exam and sometimes treatments (billed by [redacted] ). Other bills related to specific services may be also received. These may include bills from a radiologist for interpreting any radiological tests, a pathologist for reading any pathology biopsies, an anesthesiologist for anesthesia administration, or charges for other specialty services. Adena Health System does not charge, send the billing, or negotiate for all these entities. [redacted] is the company that employs and managers the providers (physicians, physician assistants, and certified nurse practitioners) in the Emergency Department. Adena is not involved in their billing process. This billing process is common with other hospitals that use a vendor to employee physicians and bill for physician services in Emergency Department . However, it is our understanding that if a patient has applied and been approved for financial assistance, [redacted] takes this into consideration. We recommend that you contact [redacted] for assistance with their billing and ask about its financial assistance program . Another possible option is to fill out and apply for Adena Financial assistance and if you are offered assistance with Adena you can use and have proof for your bill [redacted] and it may get discounted by their discretion. Thank you for allowing us to investigate this concern.
I reviewed the response made by the business in reference to complaint ID ***, and find the resolution is satisfactory to meThis puts me back at square one*** is who I set up the payment plan for dollars a monthThey said it was perfectly fine and to make sure I paid all the payments on timeAnd everything was great for monthsAnd then adena calls me saying I have to pay a month with no incomeI've already set up a billing program through ***Thank you very muchI hope everything is resolved nowI had to pay different doctor bills and all the doctor done was give me a wrap for my hand and a ice packHe never looked or even felt my hand, and it's been about months since it happened and my hand is still the same from the day I went to the hospitalI'll pay the agreed amount of dollars a month as agreed with from *** months ago
Adena Health System is sorry to hear of this misunderstanding. When a patient goes to the Emergency Department, they may receive bills for multiple services depending on the care provided These will include a charge from the hospital for the use of the facility, supplies, testing,...
staffing, etc. (billed by Adena), and a professional charge from the provider who performs the medical exam and sometimes treatments (billed by [redacted]). Other bills related to specific services may be also received. These may include bills from a radiologist for interpreting any radiological tests, a pathologist for reading any pathology biopsies, an anesthesiologist for anesthesia administration, or charges for other specialty services. Adena Health System does not charge, send the billing, or negotiate for all these entities. [redacted] is the company that employs and managers the providers (physicians, physician assistants, and certified nurse practitioners) in the Emergency Department. Adena is not involved in their billing process. This billing process is common with other hospitals that use a vendor to employee physicians and bill for physician services in Emergency Department . However, it is our understanding that if a patient has applied and been approved for financial assistance, [redacted] takes this into consideration. We recommend that you contact [redacted] for assistance with their billing and ask about its financial assistance program . Another possible option is to fill out and apply for Adena Financial assistance and if you are offered assistance with Adena you can use and have proof for your bill [redacted] and it may get discounted by their discretion.
Thank you for allowing us to investigate this concern.
Below is the communication between the Patient Advocate office and the practice manager for Dr. D[redacted]' practice:
We
are definitely a patient advocate. We are happy to do prior
authorizations when they are required. The medication in question is Viagra.
Dr
D[redacted] is happy to...
prescribe the medication, however it is the patient’s
insurance company that is refusing to pay for the medication. We have
attempted on several occasions to get this type of medication prior authorized
for several patients and every insurance refuses to cover it- using their terminology
“it is not medically necessary”.
Per
Dr D[redacted], 100% of her patients who receive this type of prescription are
informed when she initially prescribes it that insurances very rarely cover
this and that it is out of pocket for the patient.
To Whom it may concern:The office has been contacted and the practice manager has indicated Dr. D[redacted] will fill out the prior authorization form to the best of her ability. The patient may be required to try other medications before approving the Viagra depending on his insurance. This patient will also be referred to a Urologist so he can get specialized care for this issue. The office is contacting the patient to communication this information.
But, as of 04/18/2016 the "prior authorization" is still waiting to be signed and returned to my prescription insurer. And the receptionist, Donna, told me over the phone "...they do not do prior authorizations per policy...". I would be fine with the decision being made by my prescription insurance company BUT Dr. D[redacted] has not returned the prior authorization. I just ask that Dr. D[redacted] sign and return the "prior authorization"....