California Emergency Physicians

We had sent a duplicate invoice on 12/10/14. However, as a courtesy, on 1/8/15, we mailed another copy to the address indicated on the complaintKind regards, [redacted]

I am rejecting this response because: First I prefer that this response from CEP be sent to my home address in hard copy because I do not have a computer.  This is my cell phone.  Second, [redacted] has already stated several times that this bill has been paid in full therefore I disputethe validity of this bill.  I do  not owe this bill, [redacted]

A refund in the amount of $165.85 was processed and issued to the cardholder's account on 12/8/15.

It was identified that this balance was released in error and the account was resolved on 6/21/16 with the balance of $45 adjusted.  There is no remaining balance on this account.

Hello,
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Our response is as follows:
 
We attempted to bill the patient’s insurance, both private and worker’s compensation due to misinformation from the patient as to who should be billed. We attempted to reach him by phone and mail numerous times before ultimately placing the account in outside collections last February. He has since contacted us and updated his contact information. We have once again confirmed with the patient that it is a work injury and billed his employer. As of 2/5/16, we have yet to receive payment on the account.
 
Kind regards,
 
[redacted]
[redacted]
[redacted]
[redacted]
[redacted]

The patient was billed for physician charges related to her hospital visit. These charges are what her insurance carrier deemed to be patient responsibility. The patient signed an acknowledgement of separate physician vs facility billing at the time of her hospital...

visit. A copy of her signature is included in the medical record. Several statements were sent to her. However, she never responded. Ultimately, the account was sent to outside collections.
 
The charges are accurate, her signature confirms knowledge of separate billing, and several attempts to reach the patient were made without success

I am rejecting this response because: I did not get any help for the condition I end up at ER but I was billed for. I will not be paying this bill.

Review: I arrived the hospital „Marin General Hospital“ on the 08/15/2014 and left it on the 08/16/2014

Several weeks ago, you have send me a invoice of 704,00 Dollars. I payed it on the 10/07/2014 with my credit card.

See the payment below:

You have to help me please:

My german health care company needs a copy of the invoice, but I lost it- I can not find it any more. I only get my money back, if I sent them the bill.Desired Settlement: Could you please sent me copy of the invoice again? If your want to my email address: [redacted] Thank you so much!!!!!

best regards

greetings from germany

Business

Response:

We had sent a duplicate invoice on 12/10/14. However, as a courtesy, on 1/8/15, we mailed another copy to the address indicated on the complaintKind regards, [redacted]

Review: I was seen in the ER two time within two days. The 2nd visit I was told would be at no charge to me due to misdiagnosis.

Dr Dean on 5/8/11 saw me because I called in to the ER after being seen on 5/6/11 feeling out of breath, fatigued and could not keep food down. I was told I had bronchitis. Being someone who gets bronchitis every year (very familiar with how I feel) I was pretty vocal that is not what I had but was sent on my way anyhow with no further testing.

When I woke up on the 7th weaker then on the 6th I called into the hospital ER and voiced how I was doing and how I felt pushed aside from the previous physician. I was told by the overseeing MD to come back in to the ER when I could and I would be seen again. I expressed my concern as I did not have insurance. I was told that I would not be charged for any physician fees due to feeling I had a misdiagnosis if something else was found.

At this time I went in and saw DR. Dean who discovered I was misdiagnosed and I ended up having pneumonia and it was a good thing I came back in because it was only going to get worse not better.

Now I have come to find out that I was charged for being seen on the 8th after and I AM FULLY CONTESTING THIS.Desired Settlement: I want the charges to be dropped for the visit on 5/8/2011 because I was misdiagnosed on 5/6/2011 and if I was properly taken care of at the ER like I should have been then the mis diagnose would not have happened.

Business

Response:

Initial Business Response

After careful review of the patient's medical records for May 6, 2011 and May 8, 2011, our Medical Director has deemed that the treatment and care provided to Ms. [redacted] on both dates of service were appropriate and within accepted standards of practice for her presenting problems.

Ms. [redacted] was offered a discount on 7/6/11 in an effort to assist her. We are still willing to work with her on a payment schedule, if necessary. However, any future claims of misdiagnosis will not be considered.

Final Consumer Response

(The consumer indicated he/she DID NOT accept the response from the business.)

I need the creditor to ensure that this will be taken off my credit report in full if I pay the 50 percent. No one will give me a straight answer.

Final Business Response

The patient was contacted on November 7, 2013 and was again offered a significant reduction on her account balance. We have reviewed this account several times and she is aware of that. We will not consider any future claims.

Review: My son received services from this group on April 10, 2013. Although they were given insurance information several times, they continue to bill me.

My son was injured at school on April 10, 2013 and went into cardiac arrest. He was transported to the hospital where he subsequently passed away. I began receiving bills from this organization. I called and spoke with them on the phone and I wrote several letters explaining that he had insurance and the bills should be submitted to the insurance company. Yet I continue to receive bills from this organization and they are threatening to send this bill to a collection agency.Desired Settlement: I want them to collect their fees from the insurance company and stop bothering me with this. The pain of my loss is bad enough without being harrassed by this group.

Business

Response:

Initial Business Response

We received the correct billing information from Ms. [redacted] on 9/23/13. The insurance carrier was billed on 9/24/13 and we will notify Ms. [redacted] of the outcome once the carrier has adjudicated the claim.

Final Consumer Response

(The consumer indicated he/she ACCEPTED the response from the business.)

After I filed my complaint with the Revdex.com, I did contact them again to try to clear this matter up. This time they were able to verify the insurance coverage for my son and said they would finally bill the insurance.

Review: I was seen at Advenist Health Hospital. I am not disputing the amount of the bill. I trust that the amount was correct based on the explanation of charges my (then) insurance carrier sent me. What I am disputing is that I was making payments, and then all of a sudden I was not receiving any statements from California Emergency Physicians. I was paying on-line, and thus with out the statements (I shred them after I make a payment because I don't want any information stolen) I could not find get online to pay. I received no new statements, and then I received a bill from a collections agency. This is ridiculous and irresponsible treatment. I was making payments, and then to send me to collections is ridiculous. All I am asking is to get an actual statement: 1)so I can make a payment and 2)so I can see that my payments are being reflected on my account. Absolutely ridiculous. I understand doctors need to be paid, and I understand businesses need to make money. But don't ding me, or not send me a statement when I am making payments. I don't have a problem paying, but at least show me my balance and where I can pay. Don't just stop all of a sudden.Desired Settlement: In order to resolve this, I would like a statement sent to me showing my previous payments, my balance, and the information where I can pay on-line.

Business

Response:

Per the patient's request, a statement was sent to his confirmed address. He then paid the total remaining account balance and the account was subsequently removed from outside collections. He now has a zero balance and there is no collection activity.

Review: I just received received a "FINAL NOTICE" bill for $55.34 dated December 28, 2015 which I had paid in full on Decemer 8th. This is reflected the n my bank statement. When I went online to their billing service it stated I still owed the same amount for the same account. Upon further reviewing my bank account online, the amount of $55.34 for the same account was also paid on November 3rd, 2015.Desired Settlement: Apply payment immediately to avoid unwarranted collections activity and damage to my credit. Refund my overpayment.

Business

Response:

The patient has three accounts with the same account balance. When payment was submitted without an account number attached, it was applied to one account, leading to a credit balance. The other accounts still showed outstanding balances, for which the patient was sent statements. We have since issued refunds to the patient's credit card for the overages on the first account. However, outstanding charges remain on the other two accounts. We have reached out to the patient by phone and have left a direct call back number to discuss the account balances/ credit balances with her. As of 1/19/16, she has not returned our call.

Review: On 8/27/15 I end up in San Mateo ER with severe eye infection. Pain, swelling around the eye. I did not sleep or eat for few days because of the condition. The doctor decide to ignore my symptoms and treat my high blood pressure instead( which was high because of the pain and stress related to the eye infection). When I got the feeling that I will not get help I tried to live but the nurse said that more testing needs to be done. I was still hoping that the testing is for the infection. It was not. I left hospital with the same pain and even more stress. Two weeks later I got a help from the other doctor. Three months later I am still on the medication, the eye is still swollen, the pain is almost gone. I still may need a surgery. I receive a bill for that day for $480.00. I sent 3 letters asking for cancelation of the bill because I did not get any help. I included a picture of my very disfigured eye.I did not hear back from them. If I would get help on 8/27 at ER the infection would be gone long time ago. They did not help me but they want me to pay them.Desired Settlement: Cancelation of the bill.

Business

Response:

December 15, 2015 [redacted]

[redacted] Re: Account [redacted] Location San Mateo Medical Center - Emergency Department Service Date August 27, 2015 Dear Ms. [redacted]: As billing agent for California Emergency Physician’s America, I am writing in response to the letter(s) received concerning your bill for services. Our office takes your concern seriously and requested the physician group’s Medical Director to review the encounter information. Based on his response to our office, the charges are accurate for the service provided and care was deemed appropriate and within accepted standards of practice. In addition, we have confirmed that the facility’s Review Board has met and reviewed your case. They concur with our decision. If you wish to review the medical record, please contact the hospital’s medical record department. Please remit payment within the next 10 days or contact our office at [redacted] if you have any questions or to see if you qualify for a Hardship Reduction. You may mail in your payment with a copy of this letter or log in to our payment portal at [redacted] to use your credit card to remit payment. Sincerely, [redacted] RHIT MBSI- Assistant Compliance Manager

Consumer

Response:

I am rejecting this response because: I did not get any help for the condition I end up at ER but I was billed for. I will not be paying this bill.

Review: I was treated by an emergency physician at John Muir Hospital in Walnut Creek, CA the evening of 8/25 & 8/26/2014. I did not receive any sort of bill for the ER doctor's charges until 1/3/2015, when I received a letter from a collection agency named Stanislaus Credit Control Service Inc dated 12/17/2014. This letter did not provide any documentation or proof of the debt the company was attempting to collect. I promptly contacted CEP on 1/5/15. An employee said that CEP didn't attempt to bill me until 12/1/14 (after I had just moved out of the country), then immediately sold the debt to the collection agency on 12/5/14. I asked for documentation of the alleged charges, which I received on 1/14/15. I tried calling CEP several times to pay the requested charges ($66.48), finally reaching an agent on 1/26/15. However, the employee refused to take my payment, saying that my 30-day grace period ended on 1/5/15, approximately the same time I received any notice of the alleged debt.Desired Settlement: I would like to make payment of the requested $66.48 directly with CEP. Additionally, it is imperative that both CEP and the collection agency refrain from placing a negative report of this debt on my credit report, as any delay in payment was in no way my fault. I resided at my original billing address in the US for three months following the date of treatment and registered for mail forwarding to France, yet still did not receive any correspondence from CEP for 4.5 months.

Business

Response:

As per our contract with your insurance carrier, statements are not sent to the patient until the final determination of patient responsibility is received by the carrier. Final determination was made in November, 2014 and a statement was sent on December 1. The statement was subsequently returned as undeliverable on December 3. A courtesy call was made on December 4th. However, the phone number on file was disconnected.Although the account was billed and referred to an outside collection agency appropriately, as a courtesy, we have removed the account from Stanislaus Credit Control Service. You may contact us at 800-198-7157 to arrange for payment.

Consumer

Response:

I have reviewed the response made by the business in reference to my concern, and find that this resolution is satisfactory to me.

Review: I am being billed by this group for unknown reasons. I was billed my deductible by [redacted] and settled that bill with them. I have never been billed by this group for a hospital visit before and have no idea why I am being billed by them now. It is reflecting negatively on my credit-when the hospital bill has already been paid with the hospital.Desired Settlement: I would like for them to remove all charges and negative credit reporting. I would also like to know exactly why I am being billed by them, when my hospital bill was paid to the hospital. I am also insured, so I should have no other cost other than my deductible.

Business

Response:

The patient was billed for physician charges related to her hospital visit. These charges are what her insurance carrier deemed to be patient responsibility. The patient signed an acknowledgement of separate physician vs facility billing at the time of her hospital visit. A copy of her signature is included in the medical record. Several statements were sent to her. However, she never responded. Ultimately, the account was sent to outside collections.

Received a bill from these people for ER services by an MD at [redacted]. Called them immediately upon receipt of invoice to let them know I would be paying my portion of the charges in installments (insurance company already paid their portion) -- experience is that it pays to let them collecting group know stat that you won't be paying the entire balance due, unless of course you can.
The guy on the phone was very polite, agreeable, understanding and accepting of my proposal. He also asked a few questions and said I qualified for a reduction in my share. Of course I was thrilled and appreciative -- never has this been offered. In fact, usually these companies are completely unyielding and unsympathetic.
In short -- I wish every time I have to pay my portion of an MD bill that it be handled by these people! A refreshing change from the norm!

Review: CEP continues to try to collect for the provider discount and duplicated fee portion for services billed/settled by myself and my insurance company.

On 8/14/12 I had to go to the emergency room of Memorial Hospital in Modesto,CA for a urinary tract infection when I was on vacation. The clinic referred me there because their computer system was down that day and that was my only alternative. I did not know anywhere else to go.

I called my insurance company ahead of time to inform them of the situation and get approval for treatment in the emergeny room.

The hospital and CEP, the attending emergency physician's employer, set their bills directly into my insurance provider, WPS (Wisconsin Physicians Service Ins), who determined the in-network provider discounts and informed me of my portion of deductible owed to each service provider.

Memorial Hospital's bill was for $3,302 in total, less $660.40 in provider discounts, for a net of $2,641.60. CEP's bill was for $343. However, WPS informed me on their Explanation of Benefits statement of 10/22/2012 that $41.00 of CEP's bill was for duplicated/already included procedural charges, and if CEP disputed this for them to forward additional information into WPS. Apparently CEP adjusted their bill and submitted to WPS a second time for the total amount of $302.00 on 12/13/2012. WPS's in-network provider discount on CEP's bill was $218.29, thus leaving a balance owed of $83.71.

I forwarded payment on 11/26/12 to both Memorial Hospital (A#XXXXXXXXX) for $2,641.60 [redacted] and to CEP (A#XXXXX-XX)for $83.71 [redacted] in settlement for my portion of their charges on my account with each of them. I thought everything was paid that I owed, and heard nothing further from either until in late March 2013 when CEP forwarded a billing statement dated 3/26/2013 directly to my house invoicing me for $259.29, which is the discounted in-network provider amount of $218.29 plus the $41.00 duplicated charge that WPS denied, and that CEP had already adjusted off of their second submission to WPS.

I contacted WPS by phone in April and again in May after I received monthly statements from CEP beginning in March of 2013. I have also spoken to a CEP's Medamerica account rep. As far as WPS is concerned, I and WPS do not owe CEP anything more, but CEP's Medamerica accounting/bill collection agency is continuing to state that I owe CEP the $259.29 and is now threatening to turn me over to a collection agency as of their last statement dated 5/13/2013.

This is not right on CEP's behalf. As an in-network provider contracted with WPS they should not be allowed to continue to insist nor collect the provider discounted portion of their billing or for the doubled up charge.Desired Settlement: I want CEP's Medamerica collection service to account for the insurance provider discounted portion correctly, to write off the duplicated/already included procedural charge of $41.00, and to correctly bring down what is owed to CEP to zero on my account balance.

Further, I want for them to forward a statement to me showing that my balance is zero as well so that I do not get a "surprise" 4 months later.

Business

Response:

Business' Initial Response

Patient [redacted] was treated by a California Emergency Physicians America ( CEPA ) clinician at Sutter Memorial Hospital in Modesto, California on August 14, 2012. He was charged $302.00 for Evaluation and Management service XXXXX and $41.00 for Pulse Oximetry diagnostic.

MedAmerica Billing Services ( MBSI and billing agent for CEPA) billed the patient's insurance carrier ---WPS Health Insurance---on September 13, 2012. WPS adjudicated the claim and MBSI received an explanation of benefits on November 10, 2012. WPS stated non-contracted with CEPA and applied $83.71 to patient deductible with a remaining balance of $ 259.29 applied to patient responsibility.

As a gesture of goodwill MBSI filed a Provider Dispute Resolution (PDR) under AB-1455 guidelines on November 19, 2 012 to patient's insurance carrier WPS; no resolution or additional payment/information was received by WPS.

MBSI has removed the encounter from outside collections and will adjust the pulse oximetry balance of $41.00 from the patient's outstanding monies owed. This is a one-time consideration. The billing supervisor will contact Mr. [redacted] directly and advise him to contact his insurance carrier as the issue appears to be related strictly to the language of the insurance parameters.

Additionally, we will offer Mr. [redacted] the consideration of a 50% hardship reduction on the remaining balance if applicable.

Consumer's Final Response

(The consumer indicated he/she ACCEPTED the response from the business.)

WPS forwarded their revised EOB, and CEP forwarded their billing statement last week which finally reflected the same information provided by WPS as to the actual accepted/negotiated provider charge for the services rendered, the removal of the duplicated charge, and the correct application of the payment forwarded initially.

So I forwarded payment for the adjusted balance on the bill last week and the account is paid in full at this time.

Thank you for your help in straightening out this matter as I could not get CEP to talk to WPS, and visa versa, after each basically stated they were each correct, and neither wanted to budge in the beginning. I was caught in the middle, and it was going nowhere until I contacted your office.

The account is paid in full and the matter should now be closed.

Again, thank you for your time and consideration.

Business' Final Response

We received a revised EOB from WPS on 7/25/13. We have processed accordingly and sent a revised statement to the patient on 7/29/13.

Review: received a letter that I had been to an ER, which is true, and I had been scene by one of there Drs. I do not know. No name in letter. No dates

On 6/13/13, I went to [redacted] Emergency Room in [redacted] I gave all my information (which included my [redacted] Card ID, address, Social Security) to [redacted] at that time. As far as I know, every bill has been paid At the end of June, on the 29th, I received a letter from Med America, stating I had "Recently been scene at an Emergency Room and had been scene by one of their physcians", and to contact them promptly. I have been trying to contact them since 6/30/13, the only Doctor I saw at [redacted] has been paid. I do not know what physican they are talking about. They do not answer their phones. I believe this bill (not evan a bill) is bogus. If you can get through to them, I want an itemized bill, with names, date and what treatment I received. I do not want them to call me. I want a letter and itemized bill.Desired Settlement: I want an itimized bill : Drs name, hospital I was at and what was done; date I was scene. Once I have all that information I will contact my insurance company. And contacted by mail--NO phone calls!

Business

Response:

Business' Initial Response

The statement Mr. [redacted] is referring to is for the emergency department provider's services. Those services are billed separately from the hospital.

On 6/28/13 we spoke with Mr. [redacted] in order to obtain his insurance information so that we may bill them directly. He stated that he did not have the information available and would phone us the next day. We have not heard from him until now. If he would like to phone us at XXX-XXX-XXXX so that we may assist him in settling the claim, we would be happy to help him.

If he would like specific information regarding his treatment, he should contact Sharp to obtain copies of his medical records.

Consumer's Final Response

(The consumer indicated he/she DID NOT accept the response from the business.)

No, they did not contact me. That is all I want is the itemized bill and doctors' name. I feel that they are bogus. I am going to call the Attorney General's office.

Business' Final Response

A letter and a copy of Mr. [redacted]'s statement has been sent via USPS. The letter and statement contain the facility name, date of service, physician name, and explanation of charges. It also includes contact information so that Mr. [redacted] may contact us with any questions.

Review: I paid my bill for $165.85 twice. Once on 10/14/2015 and once on 10/31/2015. I called immediately on 11/2/2015 and was told a refund would take approximately three weeks, even though they could clearly see it in the system that I was owed a refund.Unfortunately, I had several medical bills at the time, hence my oversight. However, I have waited over a month now for a refund which the representative I spoke with could clearly see was owed to me a month ago. Meanwhile, the credit card used is eating interest based on the extra charge.Account #[redacted] transaction ID: [redacted]Desired Settlement: I expect a full and prompt refund of the $165.85 I overpaid.

Business

Response:

A refund in the amount of $165.85 was processed and issued to the cardholder's account on 12/8/15.

Review: I was taken to the ER Jan 21st by my husband after having 5 seizures. Ridout Medical center would not except my California State Medi-cal just because we had gotten married and it had my maiden last name on it but yet every other place has taken it and not had an issue. My husband said we sat their as I had drool running down my face and I was shaking for 4 hours and no one took care of me. So he decided he was going to leave and take me to another Hospital 45 Mins away to Kaiser in Roseville, I did get treatment there that day an hour later and I did get my Medi-cal card taken there, they did everything I needed and took great care of me right away, for 1 I should not be receiving a bill I did not get treatment for , for 2 I never received a bill in the mail for this just this Collection bill in the mail which I do not think should go on my credit as I have insurance and they would not except it . I am making a copy and sending it in and also Writing a letter to Medi-cal and letting them know why there is 2 bills in 1 day for 2 hospitals and which 1 should be paid .I should not be taken to Collection at all by Rideout for no service at all.I could have had another seizure while sitting there .I think this should be removed from my bad credit for something I did not do . Thank youDesired Settlement: I think it should not be sent to collection as I was taken to another Hospital that day and treated for not being cared for after sitting for 4 hours . Also it was not my fault they would not take my insurance . I am sending in a copy even though I shouldn't have too

Business

Response:

June 19, 2015 [redacted]

[redacted] Re: Account [redacted] Location Rideout Memorial Hospital - Emergency Department Service Date January 21, 2015 Dear Ms. [redacted]: As the billing agent for California Emergency Physicians, I am writing in response to your concern regarding your bill for services. We sent statements to the above address on 2/23/15, 3/23/15, and 4/20/15 with no response from you. EMTALA (Emergency Medical Treatment and Labor Act) requires hospitals/providers to provide an examination and needed stabilizing treatment, without consideration of insurance coverage or ability to pay, when a patient presents to an emergency room for attention to an emergency medical condition. You received a rapid medical evaluation by Sokkunthair Kem, N.P., under the supervision of Mark Agness, M.D. prior to your decision to leave the emergency room. The criteria used to determine the evaluation and management level for the professional service is not the same as the criteria used to determine the level for the facility charge. Emergency department services are not based on provider face-to-face time but can include provider orders for labs, imaging, medication, etc. Facility charges are billed separately. If you wish to review the medical record, please contact the hospital’s medical record department. Please contact the facility to address your concerns regarding their acceptance of your insurance information. However, you may contact us at 877-498-7157 with the information needed to bill your insurance, to make payment on the account, or to discuss a possible discount. Sincerely, [redacted], RHIT MBSI – Assistant Compliance Manager