Adirondack Park Pet Hospital

To Whom It May Concern,
I forwarded this complaint to the La Jolla Memorial hospital Risk Management department to review and respond regarding complaint
Sincerely,
Wendy Sweet, Manager of Risk/Patient Relations for Scripps Foundation

After review of this complaint I have found the patients payment of $has been received and the balance is now zero. This patient will not receive any more bills. Thank you, *** ***Manager, Revenue Cycle858-927-

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint.
Regards,
*** ***

Dear *** ***,
Thank you for bringing this to our attentionWe have reviewed Mr***’s concerns regarding the charges for an annual physical and repeated laboratory testsWe have determined that the care was appropriately delivered and the second set of labs were ordered due to abfindings from the first set of lab tests
Regarding his annual physical exam the provider identified that the patient had concerning physical findings that required additional counseling for treatment, patient education and instructions for health maintenanceTherefore charges for the physical and labs are valid contractual to his insurance company
Sincerely,
*** *** Manager of Risk/Patient Relations

I have confirmed with the office of the doctor and I was present during the visit: the service provided and contracted was a general check up for my son
The service billed and charged was something else, based on notes of leg stiffness that are not accurate and did not take more than a few seconds of a nurse, that took a picture of a spider bite with her phone and show it to a person passing on the hallway, that was it
The check up was and I asked several questions as part of the check up, nothing out of the norm
A nurse acknowledged this, as well as people in billing Department, but everyone point back to the doctor, only person that can change it and who had no time to receive us to correct this, even when I waited for hours in his office
The waiver is part of the documents you HAVE to sign to get a check up, it does not imply you can charge whatever you want and I have to pay itIf the service is coded correctly, coverage should be corrected too
The service was not correctly coded, this practice is a fraud, it is unnerving that you can do this with impunity
I will look for other places to denounce this fraud until I am heardMedical Boards, defense of consumer or someone will end up doing something about this abuse
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
Regards,
** ***

Revdex.com of San Diego,
Thank you for forwarding the customer's concern to the attention of Scripps ClinicThe customer was contacted and resolved to their satisfactionNo further action is needed
** ***, Patient Relations

Good morning Revdex.com of San Diego,
This is in response to Mr***s concerns sent to your attentionMr***'s concerns were reviewed by the clinical/administrative oversight and a letter was sent to the patient's attention with the outcome of their review
** ** *** Patient Relations

I'll forward to Business Services to reviewThis concern was investigated for DOS 11/16/by the Business ServicesI'll have them review it again and send update to patient
Sincerely,
*** ***, Manager Risk and Patient Relations

Revdex.com:
I have reviewed the response made by the business in
reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
I have contacted Scripps multiple times over the last year to try to get explanation of a bill that was promised would be fully covered by the insurance companyI have sent multiple emails and letters, as well as messages with the front desk and nurse and have not heard from the doctor ONCEI even filed a complaint with the Revdex.com and was not contacted at all to discuss the matter by ScrippsMy latest messages have not been returned and I finally got an email response saying that the matter has been resolved and no further action will take placeThis is not acceptable because I did not even want the tests taken done but the doctor told me they were required by law, but that since they were required the insurance company would have to pay for them.Desired Outcome: Bill needs to be adjusted

Good morning Ms***,
Thank you for the opportunity to respond to Mrs***’s complaint regarding the bill generated from her daughter’s visit to Scripps Clinic sent to your office for resolution
We are very sorry this happened, and we are doing a review to understand how it happenedWhile
we cannot get into specifics because of patient privacy, please understand we are doing a thorough reviewWe are working with the Business Services Department during this review process to remove this account from any collections proceedings and will be addressing Mrs***’s concerns with the primary insurance carrier
A resolution with the health plan may take up to days in this matter; during this time--I will continue to monitor and communicate any findings with Mrs*** directly
** ** ***
Patient Relations

To Whom It May Concern,
I have opened up a Risk Investigation regarding Ms***'s complaints and have reviewed her concerns with clinic Manager *** *** and Patient Relations Coordinator *** *** *** will be able to assist Ms*** with resolution of her concerns
Please contact *** *** at ###-###-####
We apologize for the delay and frustration regarding Ms***'s complaints
Sincerely,
*** ***, Manager of Risk and Patient Relations

Good morning Ms***,
Thanks again for the opportunity to respond to Mrs***’s rebuttal to our initial response to her claim
As previously stated, Ms*** presented with an insurance card on the date of service--upon verification at time of service; it was determined that the prescriber, Ms*** was not eligible or not covered and an assumption of liability was signedTherefore, the charge is valid as reflected with the collection agency and Ms*** is responsible for settling this account with the agency directly
We acknowledge her concerns and regret that we cannot be of further assistance regarding this matter. We do thank you for bringing this to our attention and affording us the opportunity to address her concerns
** ** ***
Patient Relations

I disagree with their final assessmentIsn't it unfair practice to not let the patient know what tests are going to be performed? I was there with the understanding that this was a Wellness Exam and had no knowledge that the blood I was giving was for an allergen test
*** ***
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
Regards,
*** ***

To Whom It May Concern:
This is in respond to concern received on behalf of your clientAfter completing a detailed review of your issues, it was determined that the care and services provided were medically appropriate and within the standard of care for the history and symptoms presentedIn
addition, a review of the payment plan agreement with Scripps was not followed thru as agreed; therefore the agreement was voided and collection proceeding was initiatedIn the interest of good patient relations, her account was pulled from collections and terms of payment plan are being reestablishedIf client does not honor new payment plan agreement with steady payments, collection proceedings will re-initiated
Thank you for the opportunity to respond to inquiry
*** ***

There is nothing else we can do to resolve this matterWe are sorry that our solution did not meet this patient's expectation

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
I have spoken with my insurance company multiple times and they have stated that no claims were ever submitted to them by ScrippsThey have also stated to me that I was eligible for coverage on the date of serviceSince the initial verification was submitted with my name spelled incorrectly, I request that Scripps re-submit the claim to my insurance in this week with an itemized bill and the correct spelling of my name. The last invoice I received only indicated "office services" which to me does not meet the definition of itemizedI also request a fully itemized copy of my bill for my own purposes
Regards,
*** ***

To Whom It May Concern:
Thank you for the opportunity to review Mr*** concernsHer complaint was reviewed and addressed at the Patient Affairs Committe and the resolution to his concerns were addressed with him personally on May 22,
If you have any other concerns, please
contact me
** ** ***

Good morning Ms. [redacted],
Thank you for the opportunity to respond to Mrs. [redacted]’s complaint regarding the charge for her son’s visit sent to your office for resolution.
An audit was conducted by the Business Services team and it was determined that the care and service provided were coded and...

billed appropriately as determined by the primary insurer health plan. The charge was assigned to the patient’s deductible. A waiver was signed by Mrs. [redacted] acknowledging—should insurance company not cover the charges; she would be financially responsible. Therefore, it was determined that the charges are valid and Mrs. [redacted] is responsible for bill as reflected with the collection agency. Due to the lapse in time, Mrs. [redacted] must settle the bill with the agency directly.
We acknowledge her concerns and regret that we cannot be of further assistance regarding this matter.  We do thank you for bringing this to our attention and affording us the opportunity to address her concerns.  If I can be of future assistance regarding other issues please do not hesitate to contact me directly.
 
[redacted]
Patient Relations

This complaint is not in regards to the medical care received, but the issues faced with the billing and payment applications departments. This detail was provided within the dispute and should be addressed.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]