Bend Memorial Clinic LLP

June 10, 2016Revdex.comAttn: [redacted] PO Box 1000Dupont, WA 98327RE: ID # [redacted] Dear Ms [redacted] This letter is in response to a letter Bend Memorial Clinic received from your office addressing a complaint filed against us by [redacted] who visited our Urgent Care Clinic on 01/20/2016.The patient expressed dissatisfaction with the amount billed for the Flu shot and was given a courtesy discount of 20% off the billed amount of the vaccineShe was informed that the Flu Shot had increased in price because BMC had switched to a new testThe change in CPT is due to the testing methodology of the Alere-I which is an RNA (molecular test) while the old Binow Now used a Elisa methodologyThis Alere-i sensitivity and specificity are 98% while the Binox Now Flu test was only 65% and 85%.The patient also expressed dissatisfaction in the way her insurance carrier had processed her claim; it was processed to her deductibleThe patient reached out to her insurance carrier and they recommended the charges be re-billed to them as a “routine visit”After a clinical review was done, it was determined that the patient visited our urgent care clinic and the symptoms she discussed with the physician could not legally be billed as a “routine visit”She was made aware that a careful review was completed and that charges stand.Thank you,Kathleen [redacted] A [redacted] Patient Financial Complaint ResolutionBend Memorial Clinic541-706-

This is in response to a notification from the Revdex.com (Revdex.com) regarding a complaint for Date of Service 8/30/with Bend Memorial Clinic which resulted in a skin biopsy that was sent to an outside facility for processing It has been documented that the patient signed a financial consent form advising the patient "should you have a biopsy performed, our specimen(s) will be sent to a laboratory outside, and separate from Bend Memorial Clinic The testing laboratory may be one or multiple locations This will depend on the particular specimen as to the need for additional testing The services you are provided may not be covered by your insurance plan, they may be considered cosmetic or elective and/or an exclusion of your particular plan Your financial responsibility is determined by your insurance company and the plan you have chosen." A review has been performed by our Quality and Risk Manager to determine this particular procedure was appropriate for this patient at the time- Bend Memorial Clinic

Complaint: [redacted] I am rejecting this response because: Bend Memorial Clinic (BMC) had previously negotiated with this [redacted] and WAS covered in-network until a few days before my 08/30/2017 procedure. Then, again, a few days AFTER my procedure, on September 1, 2017, the [redacted] was again IN-NETWORK. It was just for the few days surrounding my procedure that Bend Memorial Clinic lost the in-network status with [redacted] leading to this SURPRISE out-of-network billing for a lot more than in-network charges. It was a very UNFAIR business practice of Bend Memorial Clinic to NOT notify me of their failure to negotiate for in-network status on the date of my procedure. In regard to this, of course, I would have assumed that the pathology company was in-network as they always had been previously. I would have asked BMC to choose another IN-NETWORK provider instead of the one they chose to use FOR ME. I had no choice, which is very unfair. This is a very unfair business practice. Signing their document did NOT state that BMC had the right to choose a provider for me, especially without asking me, particularly when they KNEW the provider they chose was NOT in-network.

Complaint: [redacted]I am rejecting this response because:
Although I am pleased to hear you finally responded to my complaint after Revdex.com's attempt to contact you three times, it took me contacting the business office and asking to speak with the supervisor to get you to respond.
There are a couple reasons I reject your response, the first being: If I had gone to St Charles ER (I wish so badly I would have done this), I wouldn't have paid one cent. I informed my Dr at BMC I had already been given the Flu shot and was not given an opportunity to decline the flu swab I was given. To state "unsatisfactory patient experience" is a lie. We pay almost $500.00 a month to receive health care. It is unethical to pay a $50.00 co-pay and be billed nearly $400.00 for a "routine office visit". The second reason I reject the BMC's response is because I was on hold with my insurance customer service and the representative took the time to speak with a supervisor and come back on the phone to tell me, "you should have been billed for a routine office visit".  That statement is not something I just came up with on my own. I was given that information from a representative. I don't know what else to say other than, I promise to never set foot on BMC property again and that goes for any member of my family.Sincerely,[redacted]

This is in response to a notification from the Revdex.com (Revdex.com) regarding a complaint for Date of Service 8/30/2016 with Bend Memorial Clinic which resulted in a skin biopsy that was sent to an outside facility for processing.  It has been documented that the patient signed a...

financial consent form advising the patient "should you have a biopsy performed, our specimen(s) will be sent to a laboratory outside, and separate from Bend Memorial Clinic.  The testing laboratory may be one or multiple locations.  This will depend on the particular specimen as to the need for additional testing.  The services you are provided may not be covered by your insurance plan, they may be considered cosmetic or elective and/or an exclusion of your particular plan.  Your financial responsibility is determined by your insurance company and the plan you have chosen."   A review has been performed by our Quality and Risk Manager to determine this particular procedure was appropriate for this patient at the time. - Bend Memorial Clinic

Complaint: [redacted]
I am rejecting this response because:  Bend Memorial Clinic (BMC) had previously negotiated with this [redacted] and WAS covered in-network until a few days before my 08/30/2017 procedure.  Then, again, a few days AFTER my procedure, on September 1, 2017, the [redacted] was again IN-NETWORK.  It was just for the few days surrounding my procedure that Bend Memorial Clinic lost the in-network status with [redacted] leading to this SURPRISE out-of-network billing for a lot more than in-network charges.  It was a very UNFAIR business practice of Bend Memorial Clinic to NOT notify me of their failure to negotiate for in-network status on the date of my procedure.  In regard to this, of course, I would have assumed that the pathology company was in-network as they always had been previously.  I would have asked BMC to choose another IN-NETWORK provider instead of the one they chose to use FOR ME.  I had no choice, which is very unfair.  This is a very unfair business practice.  Signing their document did NOT state that BMC had the right to choose a provider for me, especially without asking me, particularly when they KNEW the provider they chose was NOT in-network.

This letter is in response to notification from the Revdex.com (Revdex.com)regarding a complaint submitted by [redacted] involving the billing of chargesfor an eye exam on Dec. 17, 2014.Upon review of Ms. [redacted] account, it was noted that the appointment was scheduledfor a routine vision...

exam. Her insurance carrier was billed and charges were denied,as she did not have Vision coverage on her plan. When it was brought to ourattention by the patient that her appointment was scheduled specifically because shehas a family history of Macular Degeneration, the coding was amended appropriatelyby the physician and her insurance was rebilled.We have since received payment from her insurance and we are in the process ofpreparing a refund to the patient for monies she has paid.
Sincerely,
[redacted]

We value relationships with our patients and appreciate the opportunity to work with them to resolve billing errors if they occur. All billing inquiries should be directed to our billing department at 541-317-4200.

June 10, 2016Revdex.comAttn: [redacted]PO Box 1000Dupont, WA 98327RE: ID #[redacted]Dear Ms. [redacted]This letter is in response to a letter Bend Memorial Clinic received from your office addressing a complaint filed against us by [redacted] who visited our Urgent Care Clinic on...

01/20/2016.The patient expressed dissatisfaction with the amount billed for the Flu shot and was given a courtesy discount of 20% off the billed amount of the vaccine. She was informed that the Flu Shot had increased in price because BMC had switched to a new test. The change in CPT is due to the testing methodology of the Alere-I which is an RNA (molecular test) while the old Binow Now used a Elisa methodology. This Alere-i sensitivity and specificity are 98% while the Binox Now Flu test was only 65% and 85%.The patient also expressed dissatisfaction in the way her insurance carrier had processed her claim; it was processed to her deductible. The patient reached out to her insurance carrier and they recommended the charges be re-billed to them as a “routine visit”. After a clinical review was done, it was determined that the patient visited our urgent care clinic and the symptoms she discussed with the physician could not legally be billed as a “routine visit”. She was made aware that a careful review was completed and that charges stand.Thank you,Kathleen ** A[redacted]Patient Financial Complaint ResolutionBend Memorial Clinic541-706-2347

This letter is in response to a letter Bend Memorial Clinic received from your officeaddressing a complaint filed against us by [redacted] who visited our eye clinic on03/17/2015The patient expressed dissatisfaction with the amount billed for the eye exam andrefraction that was performed by a...

provider in our eye care department. The charges have beenreviewed and while determined that the care was appropriate, a corrected claim has beensubmitted to the insurance carrier. The charges were decreased to be more in line with theservices provided and to provide better satisfaction to our patient.
Kathleen D [redacted]
Thank you, Patient Financial CounselorBend Memorial Clinic[redacted]