Afato Medical Corporation

Review: I am writing this letter as a dispute to a bill I was given by [redacted] Medical Group, which is also Regency Urgent Care. I have put the sequence of events in bulleted form. Twice in January I visited this Medical group. Both times I called ahead to price check what their rates were I made it very clear I had a high-deductible insurance and would be paying the whole bill that day. I was quoted a price, paid in full before my appointment, and was treated. Both appointments came to a total of about $200. At no time was I told that the price I was quoted was an estimate or could change. Had I known that, I would have called around to other Dr.s. A few weeks later I was sent a statement in the mail notifying me I had a remaining balance on my bill. I called and was told to ignore the statement by someone in billing. More statements were sent with a total of $80 or so that I was told I was responsible for. I talked to someone else in billing and explained the situation. Both times I was told there was nothing that could be done and I was responsible for the bill. I was given one last phone call from Afato/Regency informing me I was going to be sent to collections if I didnt pay. I explained my case again, was told the office manager would call me to discuss it, and I never received a return call. I am now currently dealing with collections. I have been incredibly frustrated with this process. I made it very clear to the office staff in January I was paying up front. At no time was I told or even given the impression that I could be billed more. (I have been told several times I was quoted an estimate, but at no time during the call was the word estimate used.) If I had known the true rates I would have called around to other offices in town. I refuse to pay this bill. I have a very clear conscience about it. I paid what I was told to pay, and I am shocked that this office is charging me more after they received the payment they quoted.Desired Settlement: DesiredSettlementID: I would like an apology, my balance cleared, and left out of the collections process.

Business

Response:

Business' Initial Response

I do remember speaking with this patient. When a patient is seen at our medical office, we make our best attempt to quote a price for services, however there is no way for us to know what an insurance company will allow or how much an insurance company will apply to a patients responsibility. Also, the front office has no way of knowing how the medical provider will code the level of visit. This happens after the patient is seen by the provider. After the visit the claim is sent to the insurance company. They send us and the patient an EOB (explanation of benefits). This is the point when we are informed how much the insurance will allow and how much they apply to patients responsibility. Each insurance company is different. And each insurance company has numerous plans.

All patients sign a "fee not covered by insurance" when they are seen here. It goes as follows:

I understand that some fees, injections, supplies and lab tests are not paid by my insurance company. If any of these charges are not covered by my insurance, I will personally be responsible for these fees.

Mr. [redacted] has signed this statement. I can send it to you if you require.

Also, we are not allowed to "write off" balances that insurance companies deem patient responsibility. We can lose our contract with the insurance company and it's not fair to other patients. The insurance company sets the rates and the providers office and the patient have to abide by those rates per contact.

As to Mr. [redacted]'s claim that the office manager never returned his call, that is not true. I am the office manager and I did speak with him and explained what I have just explained to you.