I am writing to you in response to the concern filed June 23, 2016. The patient had concerns regarding our billing practices for [redacted] patients. We do accept [redacted] in our office, and follow their guidelines for billing our patients. Being that we are a [redacted] provider of services does not...
mean that all services that are rendered by our providers will be covered by [redacted] We attempt to go above and beyond to ensure that our patients are informed of non-covered services before the services are provided so that they can make an informed decision on whether or not to receive these services. The attached letter is handed to every [redacted] patient along with the advanced beneficiary notice of non-coverage prior to their visit. As you can see by the letter, [redacted] annual wellness visits are available through Primary Care Providers and we are deemed a specialist be [redacted] Due to the nature of the exam, many women prefer not to have their Primary Care perform that service. [redacted], as the secondary payor of the claim, must process the claim according to the primary payer. Most supplemental [redacted] plans will not reimburse for a non-covered [redacted] service. (That was the case in this situation). We will not alter a claim to [redacted], just so that it would be covered for the patient. We bill [redacted] correctly as per the guidelines (see attached). We are contacting the patient, and letting her know that we will not bill [redacted] with an invalid code for services provided. We will however, adjust her account and not send her a balance due bill along with a copy of her records since we cannot meet her requests. If you would require additional information, please let me know. Sincerely, [redacted] Practice Administrator
I am writing to you in response to the concern filed June 23, 2016. The patient had concerns regarding our billing practices for [redacted] patients. We do accept [redacted] in our office, and follow their guidelines for billing our patients. Being that we are a [redacted] provider of services does not...
mean that all services that are rendered by our providers will be covered by [redacted] We attempt to go above and beyond to ensure that our patients are informed of non-covered services before the services are provided so that they can make an informed decision on whether or not to receive these services. The attached letter is handed to every [redacted] patient along with the advanced beneficiary notice of non-coverage prior to their visit. As you can see by the letter, [redacted] annual wellness visits are available through Primary Care Providers and we are deemed a specialist be [redacted] Due to the nature of the exam, many women prefer not to have their Primary Care perform that service. [redacted], as the secondary payor of the claim, must process the claim according to the primary payer. Most supplemental [redacted] plans will not reimburse for a non-covered [redacted] service. (That was the case in this situation). We will not alter a claim to [redacted], just so that it would be covered for the patient. We bill [redacted] correctly as per the guidelines (see attached). We are contacting the patient, and letting her know that we will not bill [redacted] with an invalid code for services provided. We will however, adjust her account and not send her a balance due bill along with a copy of her records since we cannot meet her requests. If you would require additional information, please let me know. Sincerely, [redacted] Practice Administrator