Advanced Pain Management, S.C.

APM has started a complete audit of the accountShould there be a refund due it will be processed per procedure

Revdex.com Case # [redacted] replyAdvanced Pain Management has done a thorough review of all the issues Ms [redacted] raisesFirst I would like to apologize for all the calls and communication problems Ms [redacted] encountered; that is not how APM wishes our patients to be treatedAPM has reprocessed all claims and have adjusted all the accounts mentioned in the complaintAfter receiving confirmation from the numerous carriers and their representatives, which took an inordinate amount of time, APM has processed the refund of $5,This was the refund amount left after all the co-pays and co-insurance obligations, according to the insurance carrier’s contracts, were met.This check was sent to Ms [redacted] the week of October 12, Please accept APM’s deepest apologies for this problem

After a thorough review and complete audit of the account we agree that there was confusion regarding the place of service for the procedure presented to the patient Due to the confusion regarding this encounter a onetime full refund will be granted to this account and all applicable payers will be contactedWe sincerely apologize for the misunderstanding caused during this encounter and the time spent by this patient in attempting resolution

[A default letter is provided here which indicates your acceptance of the business's response If you wish, you may update it before sending it.] Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution is satisfactory to me Regards, [redacted] ***

RevDex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this does not resolve my... complaint. For your reference, details of the offer I reviewed appear below. Please reopen this complaint. I am currently still working with the vendor for resolution. The improper negative items have been removed but my credit score has not recovered from the impact. We need to contact transunion to determine if it will recover from the incorrect items. We continue to see unexplainable bills from the company and are trying to get clarification. Regards, [redacted]

Following a complete review and audit of this patient’s account, application of payments made by the patient were reviewed with her to her satisfaction. We have successfully resolved this case with the patient

Upon a complete review of all payments and interactions and payment that cleared with RSI, this account has been paid in full. We apologize for the confusion in the process. RSI informs us that because of the prompt payment to them this account was not reported and will not impact
your credit rating

APM’s billing system processes procedures in a bundled form in
agreement with contracted health insurance payorsWe have provided Ms***
a statement showing the bundled charges which offers more detail regarding her
dates of serviceMs*** is welcome to contact our billing
department for
any additional issuesThis contact information is provided on the statement
sent to Ms***
A formal audit of Ms***’s November 18, procedure was
completedThe results of the audit show that the November 18, billing is
appropriate. The fee’s Ms***
addresses in her complaint are totals before contractual write off amounts have
been applied and before Ms***’s insurance is appliedAfter contractual
write offs and Ms***’s insurance payments to the charges, she is
responsible for $in accordance with her insurance policy
We are unable to address Ms***’s comment that another facility
charged less for a cortisone injectionContracts with insurance plans differ
with each contracted facility and we are not privy to the contractual rates of
other facilities

The account in question has been audited by the audit team and they have determined the refund of $is due to the patient. The refund was delayed due to some further clinical charges being processed by the insurance carrier; once those charges cleared the insurance a refund request was
madeThat request is being processed this week and will be mailed out as soon as possibleAPM apologizes for this delay in getting the refund processed

After a complete review of all charges, co-pays and co-insurance amounts it was discovered that the patient has a $balance on the Advanced Pain Management account and an $balance on the Pain Centers of Wisconsin-Kenosha (PCW-K) accountThere is a $co-pay for visits to PCW-K and the patient paid $at the 1/25/visit$co-pay for the 2/7/and 2/22/visits were not paid at time of service leaving an $balanceWe could not find any services that were charged for but not providedAdvanced Pain Management and Pain Centers of WI-Kenosha apologize for any confusion caused by the statements sent to the patient

We apologize for the issues at handWe have worked with the collections company and have resolved the issues for this patient

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Revdex.com:
I did call the the phone number listed on my statement today 5-12-16, to make sure that there was no balanceUpon using the automated system, as they were not open at the time of my callI had to enter my account number, and date of birthThe automated system stated that there was no outstanding balance at this timeI just hope in the future down the road, that I don't receive a bill or something from a collection agency stating I owe this moneyI have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me.
Regards,
*** ***

After a thorough review and working with the involved
insurance carrier it has been determined that the patient is owed a refund of
$which will be processed immediatelyAPM apologizes for the
miscommunication with the patient and the insurance carrier

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me.
Regards,
*** ***

Revdex.com Case #  [redacted]
replyAdvanced Pain Management has done a thorough review of all
the issues Ms. [redacted] raises. First I would like to apologize for all the calls
and communication problems Ms. [redacted] encountered.  We have looked into those issues and continue
to strive to provide...

better service.   APM has reprocessed all claims and have adjusted all the
accounts mentioned in the complaint. After receiving confirmation from the
numerous carriers and their representatives, which took an inordinate amount of
time, APM has processed the refund of $39.69. This was the refund amount left
after all the co-pays and co-insurance obligations, according to the insurance
carrier’s contracts, were met.This check was sent to Ms. [redacted] the week of November 2,
2015. Please accept APM’s deepest apologies for this problem.

Advanced Pain Management has done an exhaustive review of
all telephone communication and written communication regarding this incident.
Although no clear evidence of the calls mentioned could be found enough
evidence was found that could have caused the patient to misunderstand...

the
communications. Based on that possibility Advanced Pain Management and Pain
Centers of Wisconsin Green Bay will make 
a onetime adjustment and reverse all charges for the procedures done on
July 30, 2014 and August 8, 2014.
We apologize for this misunderstanding and for the time it
took to resolve the issues.

We done a complete review of the complaint and apologize for the inconvenience of the episodes. The billing company experienced a system breakdown and before it was remedied numerous statements went out to several patients. That has been repaired. The cancelled appointment fees are auto generated...

and as soon as the patient notified us we began the refund process. The refund should be arriving to the patient before mid-June.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.Medicaid is not at fault for APM not being billed until 2016. APM was billing incorrectly. Also, according to Medicaid, my copay to PCW, for 2015, is $0. I can't be billed for copays, that PCW was not allowed to bill for in 2015. Please contact [redacted] at Forward Health to correct this. 1-608-421-6347. My payment on 3/28/16 was meant to go to PCW, but I was told that the office was not allowed to put payments towards PCW, they could only put it towards APM and APM would transfer the money to PCW, which was obviously not done. I spoke to billing on 5/17/16, and was told I had a credit of $6 on APM and that they would transfer it to PCW. But, I was then told by someone else that they probably wouldn't transfer it, and to make a payment to PCW, even though I don't owe them anything, because it won't get fixed. I am not paying money I do not owe, because APM will not correct my bill. Also, why is $6 of my payment made on 3/28/16 going to APM service dates of 9/2/15 and 10/19/15 when I paid those dates on check #1563? My copay for APM can't be more than $3 according to Forward Health. My payments this year have been APM $3 on 1/18/16, 1/25/16, 3/28/16, 4/19/16, 5/10/16, and $6 on 2/22/16. I paid $9 on 3/28/16 that was supposed to go to PCW. I also paid Access $3 on 4/19/16 and 5/10/16. Where are all these payments going, that I somehow still owe money from 2015 service dates?I spoke to [redacted] from Forward Health on 12/20/15 to find out what I owed for copays for 2015. [redacted] listed my copays as:9/2/15 $3 for APM, $0 for PCW ($3 paid on check #1563)9/8/15 $3 for APM, $3 for Access ($3 paid to APM on check #1563, $3 paid to Access on check #1562)9/21/15 $3 for APM, $0 for PCW ($3 paid to APM on check #1563)10/5/15 APM insurance payment denied because of billing issues, $0 for PCW  ($3 paid to APM on check #1563)10/19/15 APM insurance payment denied because of billing issues, $0 for PCW ($3 paid to APM on check #1563)10/26/15 APM insurance payment denied because of billing issues, $0 for PCW ($3 paid to APM on check #1563)I left a message for [redacted] on 5/17/16, to go through my copays for 2016.   
Regards,
[redacted]

The contested charges for Date of service 6/2/15 were electronically sent to the primary insurance carrier on 4 separate occasions in 2015 and 2016 June, August, October and January. Each time the carrier denied receiving the charges so they were resubmitted. We cannot send to the secondary carrier...

until the primary insurance processes the claim.  After the four attempts of submission to your primary insurance it has finally be processed and thus it has been submitted to the secondary insurance. The secondary payer originally denied and is currently in appeal with this carrier.  For the July 7, 2016 date of service a similar situation occurred.   This claim also is still out with the secondary payer, Auxiant.  We are holding all billings to the patient until all appeals are exhausted.  At this time there is no patient responsibility until the secondary insurances complete processing their claims.  We apologize for this delay which was caused by the processing timeline of the primary insurance.  With regard to the address for patients concerns, please address all concerns to our corporate office:   Advanced Pain Management 4131 W Loomis Road Suite 300 Greenfield, WI 53221 Attention: Compliance Department

[redacted] was owed $3 for service provided 9/8/2015, this transaction occurred 10/30/2015. $3 was owwed to [redacted] for service provided on 7/29/2015, this transaction occurred 9/22/2015.