Adirondack Park Pet Hospital

We investigated Mr. [redacted]'s complaints regardng lab charges from 2012, DOS 7-2-12. Patients account was turned over to collections due to the fact that we received return mail with no forwarding address. There is no documentation of any insurance on his records.

To Whom It May Concern:
 
This is in response to the your client’s concern regarding a duplicate charge for service.
 
We take issues as mentioned very seriously and use the feedback to review our processes; to correct and improve our ability to give excellent patient care and...

service. After completing a detailed review of the concerns, it was determined that the charges for copays related to an office visit are actually applied for two different dates of service; therefore are valid and part of our contract with your client's insurance company to collect on the remaining balance which is her financial responsibility. We apologize for your experience and any miscommunication.
 
Again, thank you for bringing this to our attention and for the feedback you have provided us.  If I can be of future assistance regarding other issues please do not hesitate to call me directly.
 
** [redacted]

Revdex.com:
I have reviewed...

the response made by the business in reference to complaint ID [redacted], 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 spent numerous phone calls and emails to Scripps clinic over the past few months and they have verbally accepted responsibility for the error, as the nurse practitioner, my provider, has admitted that she ordered a "preventative mammogram and ultrasound".  Yet, they seem to be unable to correct the coding with [redacted].  This has been going on since I was made aware of the bill back in 4/2017.  This is unacceptable that it is taking this long.  I question that Scripps is fraudulent regarding claims to other people as well,in order to make a profit.  I have been calling the office manager, [redacted], for updates every week or so, but I shouldn't have to be the one in charge of the correction.  I feel that Scripps should go above and beyond for their mistake and yet instead they choose to ignore me in hopes that I will go away?  I am disappointed in this health care system and wonder if I need to take this to the media for better results?  This should have been corrected months ago when they admitted to the error!  I need this escalated to someone in charge of billing or this will lead to litigation and a full out investigation of Scripps coding system.
Regards,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below
As I have already commented, the visit was a general checkup and the invoice was not, so you have to change the invoice to reflect the correct service.
You claim you did some review, but you are showing no result and you are not proving to me that my son was provided any service different than a general checkup. I was present during the consult so I would know. I would had accepted or rejected a different service and the alternative was not given to me. There is no lab test or study to back up a different service either.
Furthermore, you passed on the invoice to collection regardless several disputes in progress that I had to reiterate constantly, so you shouldn't have to passed it on to collection. Collection agency shouldn't have had to add charges since I proof the invoice was in dispute.
The doctor should have received me when I went to talk to him to clarify the issue. He just made me wait for hours.
The process to dispute your constant mistakes should be clear and you provided contradictory information on what needed to be done next.
Stop sending back messages that have no information. Correct your invoice and your mistakes and act professionally.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
Scripps never asked me for my address or insurance information. My doctor's office says they provided it to Scripps. I was referred to Scripps Lab in the same building as my doctor. I gave them the order my doctor gave me. The performed the blood work. I was given the results by my doctor. When my insurance paid him, on these two occasions, I thought everything was taken care of. No one ever suggested that I had responsibility for asking the lab if they had my address and insurance information. How would I have known that?It seems to me that Scripps should have asked my doctor for the correct information when they found that they did not have it. At the very least, they should have asked me for the information when I was there. The lab to which my doctor now sends me asks for my driver's license and insurance card and checks my address before they do any work. This is in addition to the fact that my doctor gives them my information. Had I ever had this experience before being sent to Scripps, maybe I would have thought to ask them if they needed the information. As it was, I didn't know if they were paid through my doctor, or what and I certainly did not know enough to ask about it.Scripps should take responsibility for not having done their job properly and repair the damage done to me by their lack of effective procedures.
Regards,
[redacted]

the document is complete

To Whom It May Concern,This complaint was reviewed by the UCC Department Chair and it was determined that the care rendered was appropriate and required that the patient to be evaluated at a higher level of care (the ED). We are sorry for the patient's continued dissatisfaction however the care he received was appropriate for the signs and symptoms he presented with.Sincerely,[redacted], Manager of Risk/Patient Relations

This incident was investigated by Risk Management and it was determined that the patient complaint was with billing sent to the patient for the ER physician charges. The ER physicians are contracted providers and do their own separate billing. I had our Patient Relations Coordinator, [redacted]...

[redacted] contact the ER Physicans billing busiiness office and they informed the patient that the charges in question were adjusted off on 10/18/16. She spoke to [redacted] at [redacted]. [redacted] contacted patient today and she was satisfied with the outcome.   Tell us why here...

To Whom It May Concern,
I am forwarding this complaint to Mourence Burris, Manager of Business Services for his review and comments.
Sincerely,
[redacted], RN, MSN, CPHRM
Manager of Risk and Patient Relations

Revdex.com:
I have reviewed the response made by the...

business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.They only said they will forward the complaint to the Risk Management person but have not provided the results of the review, nor addressed any of my concerns about having to pay for services at ER when I tried to handle through the Urgent Care.  I knew ER would be more expensive but that's why I tried to go through Urgent Care.  Why couldn't the Urgent Care doctor refer me to MRI which is all the ER doctor ended up doing.  I respectfully request the bill reduced as originally mentioned.
Regards,
[redacted]

To Whom it May Concern:
This is in response to your client inquiry. We have made several attempts to contact your client at the telephone number listed. A letter was sent to your client's attention at the address listed on file responding to their concerns and asking your client to contact the...

Scripps Mercy Chula Vista office
[redacted]

To Whom It May Concern,
I reviewed the complaint with the manager who agreed that the incident was erronously coded. Asof 9/1/17 [redacted] was changing the coding as a screening and not diagnostic. For any further quesitons or concerns regarding this matter please contact [redacted] at 760-901-5245 and she will work with the patient.
Sincerely,
[redacted], Manager of Risk and Patient Relations

Revdex.com:
I...

have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
This is not a resolution. It is simply a message that they are going to review my complaint. I am pleased that they are finally responding to me but annoyed that they never responded to my letter to them, only to my Revdex.com complaint.Also, I want to make sure that the person reviewing my complaint understands that they never informed me or my insurance company of the charges. Likewise, the collection agency to whom they referred the charges never informed me. Had they informed me at the time, I could have had my insurance company pay the charge. Now they wont consider it because it is so late.
Regards,
[redacted]

[redacted] was more than accommodating and assured me that everything was taken care of. She went the extra step and took care of this problem. Thank you and I am satisfied that this was taken care of. 
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]

Good morning Ms. [redacted],
Thank you for the opportunity to review Janine [redacted]’s complaint sent to our attention. My office along with the clinical and administrative oversight have reviewed Ms. [redacted]’s complaint.
After completing a detailed review of Ms. [redacted]’s concerns, it was determined, that...

the care and services provided were medically appropriate and within the standard of care for the history and symptoms presented. During her visit, there were some additional medical concerns (outside of her insurance carrier’s definition of wellness visit that are not covered) identified by Ms. [redacted]. Therefore, a treatment plan was discussed/reviewed by the doctor and additional screenings were performed; all of which generated additional charges. It was determined that the care was appropriate and charges are valid; and the request for reimbursement and waiver of charges is denied.
We regret the circumstances described and apologize if any miscommunication caused Ms. [redacted] concern and dissatisfaction. I encourage her to contact the Business Services Department at 858.784.5645 to assist with applying with financial assistance or financial relief if needed. 
[redacted]
Patient Relations, Scripps Medical Foundation

To Whom It May Concern: I apologize for the delay in response.  My name is [redacted] and I am Patient Advocate for Scripps Memorial Hospital La Jolla.  This email is to inform you that we contacted Mrs. [redacted] in November.  Please see timeline below: 11/21/16: [redacted], the Manager of Care Management spoke to Mr. & Mrs. [redacted] about their concerns.  She explained that the physicians are not employees of Scripps Health and are independent contractors.  They were informed that the billing coordinator for the physician group was contacted and will contact them regarding their billing concerns. 11/21/16: [redacted] from Marin Medical Practice Concepts, Inc.  (physician billing group) spoke to Mrs. [redacted].  She informed the patient to call her insurance and ask them to resubmit the claim.  [redacted] said the claims was resubmitted to the patient’s insurance and that it will take 30-45 days to process. 12/6/16:  [redacted] followed up with Mrs. [redacted].  She spoke to [redacted] from the physician billing group who informed her that they resubmitted a claim to her insurance and will take 30-45 days to reprocess.  [redacted] shared this information with the patient.  The manager advised the patient to follow-up with [redacted] sometime in January.  [redacted]’s contact information is [redacted] Email: [redacted].[redacted]@mmpcinc.com We do not have purview over the physician’s practices including billing, as they are independent contractors and are not employees of Scripps.  The patient was advised to contact the physician billing group if they have questions or inquiries about their bill or need assistance with payment. Thank you for informing us about Ms. [redacted]’s concerns.  If you have any questions, please feel free to contact me at [redacted] or you can respond to this email. Best Regards,[redacted] [redacted]Patient Relations/ Risk Management CoordinatorScripps Memorial Hospital La JollaQuality ManagementTel: [redacted]

Mr[redacted] indicated that the last time he spoke with Mr. [redacted] he requested that Mr. [redacted] provide him with proof from his insurance carrier that proved that we didn't bill them. Mr. [redacted] has not provided the additional requested documents. Mr. [redacted] also offered to remove the accounts from...

collections if he paid them however Mr. [redacted] refused.
We aplogize for the frustration Mr. [redacted] has expierenced. He can contact the Business Office at 888-996-3729 to review his concerns.
Sincerely, [redacted], Manager of Risk and Patient Relations

We acknowledge the consumer's 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 your concern.

To Whom It May Concern,
This complaint was forwarded to [redacted], Sr. Director for Performance Outcomes at Scripps La Jolla Memorial Hospital for follow up and response.
Sincerely,
[redacted], Manager of Risk and Patient Relations for Scripps Foundation