Association of Alexandria Radiologists, PC

Review: Services provided by: Association of Alexandria Radiologists, [redacted], Va [redacted]Tel# ###-###-####Billing Dept for AAR: ###-###-####AAR acct #[redacted].1Referring doctor : [redacted], va ###-###-####My insurance company responsible for payment: [redacted]) ;Claim # [redacted]1 Tel#:###-###-####Oct.2012 - I attended doctor office [redacted] for annual preventative care. Was referred to AAR foe mammogram and bone density (Dexa scan). I was informed by [redacted] that I would not incur copayment 7or deductible for services. Nov. 2012-I recd correspondence from [redacted] that I was responsible for payment of $90.50 because AAR sent in code showing that mammogram was considered "medical" service instead of "preventative care". Told me to inform AAR to correct code so they could pay for servicesDec 2012-I recd another corresponded fro [redacted] showing AAR sent in another claim with another claim #[redacted] for same services which [redacted] denied (fraud?)Jan. 11, 2013-I spoke with [redacted]) who said [redacted] denied claim because AAR sent claim to them as medical not preventative. I spoke with [redacted] of my doctors office ([redacted]) who stated that there office do not indicate on referral if services are medical or preventative. Subsequently, had a conference called with [redacted] rep, [redacted] and [redacted] (AAR Billing Dept). It was concluded that [redacted] would send corrected code to [redacted], which she did in my presence.July 2013-I recd another bill from AAR stating I still owed $90.50. Spoke to [redacted] who said they sent bill to [redacted] with correct code and they still refused to pay. I subsequently spoke to [redacted] of [redacted] who said they never recd corrected code from AAR.Sept. 29, 2013- I recd a bill from [redacted] a collection agency for AAR stating that this account has been referred to them for collectionI have been trying to resolve this issue for a year with no satisfaction and ask for your intervention for resolution of matter.Desired Settlement: Responsible party(s) to provide my health insurance company ([redacted]) correct code so that services at AAR is considered "preventative" care instead of "medical" care, so that [redacted] will pay for the $90.50 charges incurred.

Business

Response:

November 12, 2013To Whom It May Concern:My name is [redacted] and I am the CEO for Association of Alexandria Radiology (AAR) and I am providing this response to your letter dated November 4, 2013 which was received on November 11, 2013.I have researched the complaint and find that there was no error in the billing processes performed through AAR and our billing agent. Due to HIPAA regulations the amount of detail I can provide is limited without a signed release by the patient which was not part of the letter we received.What I can tell you is that the mammogram was coded with the proper procedure code and diagnosis code and [redacted]’s did process the mammogram payment at 100% of the allowable. There was no copayment due on the mammogram. The Dexa scan was also billed with a proper procedure code and diagnosis code and the amount allowed by [redacted]’s was processed as part of the patient’s deductible. This is where the resulting $90.50 balance is emanates from. This breakout of the two exams and their codes can easily be seen on the patient’s explanation of benefits from [redacted]’s. This is a [redacted]’s issue on how they determined they would process the claim.With a signed HIPAA release from the patient I am willing to provide the detailed information from the claims and the explanation of benefits we received from [redacted]’s.Respectfully,

Consumer

Response:

Handwritten Response

Business

Response:

January 13, 2014It May Concern:My name is [redacted] and I am the CEO for Association of Alexandria Radiology (AAR) and I am providing this response to your letter dated January 3, 2014 which was received on January 7, 2013.In an effort to help see this matter through, at my request our billing agent has refiled the [redacted] code to [redacted]. That was done on January 3, 2014 electronically as the patient had contacted the billing agent and again via hard copy with a copy of the radiology report upon my request on January 8, 2014.Once we hear back from [redacted] on the processing of this claim we will adjudicate the account accordingly. If payment is made by [redacted] we will be more than happy to promptly issue a correct refund.Respectfully,