Carepoint PC

We have reviewed the complaint and stand behind the billing on the consumer's account Our billing records indicate a total of statements were mailed to the address on file, which matches to the address listed in the consumer's complaint As per policy, all outstanding self pay balances are reported to a collection agency if no response is received within days after sending the final notice Our notes indicate the consumer recently contacted our office to inquire about the services rendered and provide insurance to bill We have reached out to the facility to verify if the patient registered for these visits, and are in process of verifying insurance eligibilityOnce verified, we will recall the balances for any visits the patient was insured for from the collection agency and bill insurance accordinglyIf the facility confirms the patient was registered in error for the visits in question, we will void the charges and notify the collection agency of the balances reported in errorThank you, [redacted]

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution is satisfactory to me Sincerely, [redacted]

Complaint: [redacted] I am rejecting this response because: the amount charge for services provided is ridiculous Sincerely, [redacted]

Patient made two payments, one on December 8, for $100, and one on January 5, for $ The balance remaining is $ Patient was sent three statements, one on November 6, 2016, one on December 7, 2016, and one on January 8, On each statement there is a dunning message stating: “Please be advised that a formal payment plan must be established to prevent your account from potentially being turned over to a professional collection agency.”The January 8, statement was a day final notice statement that stated:FINAL NOTICE! As required by [redacted] Law, this is your day noticeOur numerous attempts to collect the outstanding balance on your account have been unsuccessfulFAILURE TO MAKE PAYMENT IN FULL WITHIN DAYS WILL RESULT IN YOUR ACCOUNT BEING PLACED WITH A PROFESSIONAL COLLECTION AGENCYPlease be advised that a formal payment plan must be established to prevent your account from potentially being turned over to a professional collection agencyContact customer service at [redacted] to set up an interest free payment planPatient did not call in to set up a formal payment plan, and on February 7, 2017, the account was sent to collections Once payment is made, it takes to business days for the payment to be posted into our billing system And as soon as the payment is posted, the account will be recalled from collections

We have reviewed the account in question. The balance was reported to collections in error, but has been removed, and no negative reporting will occur on the consumer's credit

This response is being submitted by ***, the medical billing company for CarePointWe had the patient’s medical record reviewed by our in-house Certified Coder. The patient came to the Emergency Department with a sore throat. The Physician Assistant Day performed a detailed
history along with a comprehensive exam. A moderate workup of a strep test along with prescription medication in the Emergency Department and on discharge was done. Based on the documentation in the patient’s medical chart, the visit was coded and bill appropriately. If the patient would like to review his medical record in more detail, he should contact the facility, as they are the legal custodian of his medical recordThe patient contacted our office on January 25, asking what percentage discount he could receive if he paid the bill in full. For this balance ($258) we offered him a 10% discount. The patient was not satisfied with that amount and spoke with the Customer Service Supervisor. The Supervisor advised the patient she could do a 20% discount or we could offer an interest free payment plan of months. Patient was still not satisfied and requested a 50% discount, which was denied

Initial Business Response /* (1000, 5, 2015/06/02) */
*** Medical Services is filing this response on behalf of Carepoint PC*** Medical Services performs the billing services for Carepoint PhysiciansWe receive all of our patient demographic and billing information from the facility
where the services were renderedThe Medical Center of Aurora provided us with the billing address for Mr*** of *** *** *** , Aurora, CO XXXXXStatements were sent to the patient at this address on January 7, 2015; February 8, 2015; and March 8, The March statement was received back as Return Mail and the address was updated through Returned Mail Manager to *** *** *** Richmond Hill GA XXXXX-XXXX on March 20, A Precollect letter was sent on April 6, Since no payment was received, the account was turned to collections on May 4, We have contacted the facility and confirmed they still have the *** *** *** Aurora, CO XXXXX address on file and have not received any returned mailWe have confirmed with *** that they sent correspondence out to the Richmond Hill, GA addressThey have not received returned mailThey attempted to call patient at *** (the telephone number given to us by the facility) but could not leave message as machine did not identify *** B***
Initial Consumer Rebuttal /* (3000, 7, 2015/06/04) */
(The consumer indicated he/she DID NOT accept the response from the business.)
Only one bill was received at the *** *** XXXXXX and that was a collection notice plus as I requested a detail bill of the services renderThe P.OBox in *** *** had a forward on it so all mail should of forwarded for a year since july of It seems strange that I have received mail from that same po boxAgain I want a detailed bill of services render The address is incorrect and not a address I residue at all correspondence should be to the *** *** XXXXXX *** ** XXXXX.I t interesting that they send the collection to that address but no billsIf they are making a charge then they them send a detail bill to the po box
Final Business Response /* (4000, 9, 2015/06/11) */
*** has cancelled Mr***'s account at *** and the account is back in house with *** Mr***'s address has been updated to the P.OBox reflected on the Revdex.com DisputeWe contacted the facility again and they still have the original address provided to them of *** *** *** *** cannot speak to Mr***'s mail not being forwarded to his current address by the post officeAs for the *** collection notice, they sent it to the same Richmond Hill Post Office Box that we received from Return Mail ManagerWe will send Mr*** a letter indicating his bill has been cancelled at the collection agency and will include a statement for his reviewWe have reset the aging on Mr***'s bill, and we will set his next statement to go out tomorrow, 6/12/

We have reviewed the complaint and stand behind the billing on the consumer's account.  Our billing records indicate a total of 8 statements were mailed to the address on file, which matches to the address listed in the consumer's complaint.  As per policy, all outstanding self pay...

balances are reported to a collection agency if no response is received within 30 days after sending the final notice.  Our notes indicate the consumer recently contacted our office to inquire about the services rendered and provide insurance to bill.  We have reached out to the facility to verify if the patient registered for these visits, and are in process of verifying insurance eligibility. Once verified, we will recall the balances for any visits the patient was insured for from the collection agency and bill insurance accordingly. If the facility confirms the patient was registered in error for the visits in question, we will void the charges and notify the collection agency of the balances reported in error. Thank you,[redacted]

Initial Business Response /* (1000, 6, 2015/07/22) */
Beacon Medical Services is the billing company for CarePoint and is responding to this complaint on CarePoint's behalf.
CarePoint terminated its contract with Aetna on 7/1/14. As a result, Aetna processed the claim out of network, utilizing...

its Reasonable and Customary Allowance. As an out of network provider, CarePoint is not obligated to adjust off any amount over the Reasonable and Customary Allowance. [redacted] and [redacted] (who is the patient) called Beacon Medical Services on 4/3/15 saying they felt they were lied to by facility regarding contracting status between Carepoint and Aetna. They stated they had filed a complaint with the facility regarding the matter. Mr. and Mrs. [redacted] were instructed to contact Aetna and request the claim be reprocessed as in-net, since it was an emergency visit.
We received a call on 7/6/15 from the facility, North Suburban. They also received a Revdex.com Complaint regarding CarePoint not being contracted with Aetna. In speaking with the North Suburban contact, they said the patient was told that North Suburban was a contracted provider with Aetna. They made no mention that they had informed the [redacted]'s that CarePoint was contracted with Aetna. The facility would have no knowledge of the contracting status that exists between an insurance carrier and CarePoint. The facility would only be able to speak to the contracting status that exists between them and the specific carrier.
Beacon Medical Services filed the claim appropriately, and there was no fraud committed. It is the carrier's determination whether to process claims at either the In-Network Benefit Level or the Out-of-Network Benefit Level. Mr. and Mrs. [redacted] should contact Aetna and request they reprocess this claim as in-net and issue additional payment.
Initial Consumer Rebuttal /* (3000, 9, 2015/07/24) */
(The consumer indicated he/she DID NOT accept the response from the business.)
This is classic passing the responsibility to someone else. We were lied to by North Suburban and CarePoint/Beacon Medical Services. If CarePoint terminated its contract with Aetna on 7/1/14, why didn't North Suburban inform us of that when we went in for services on 11/17/14 which was several months later. Instead, the ER representative notified us that all services were in-network (which includes physician services). A facility has no knowledge of a contracting status that exists between an insurance carrier and CarePoint? First of all, if they didn't that knowledge that is horrible business practice. How long does that take to look up? Second, even if they didn't have knowledge, why didn't the facility tell us that up front? Instead they lied and stated all services are in-network. As a consumer, wouldn't you want to know up front what services are covered and in-network? It seems to me that CarePoint wants to assume no responsibility and to throw the responsibility on Aetna. The other issue which hasn't even be mentioned is that the physician's fee was $695. This was to tell my wife that she had stomach flu!

Complaint: [redacted]
I am rejecting this response because: the amount charge for services provided is ridiculous.    
Sincerely,
[redacted]

Patient made two payments, one on December 8, 2016 for $100, and one on January 5, 2017 for $80.  The balance remaining is $84.08.  Patient was sent three statements, one on November 6, 2016, one on December 7, 2016, and one on January 8, 2017.  On each statement there is a dunning...

message stating:  “Please be advised that a formal payment plan must be established to prevent your account from potentially being turned over to a professional collection agency.”The January 8, 2017 statement was a 30 day final notice statement that stated:FINAL NOTICE! As required by [redacted] Law, this is your 30 day notice. Our numerous attempts to collect the outstanding balance on your account have been unsuccessful. FAILURE TO MAKE PAYMENT IN FULL WITHIN 30 DAYS WILL RESULT IN YOUR ACCOUNT BEING PLACED WITH A PROFESSIONAL COLLECTION AGENCY. Please be advised that a formal payment plan must be established to prevent your account from potentially being turned over to a professional collection agency. Contact customer service at [redacted] to set up an interest free payment plan. Patient did not call in to set up a formal payment plan, and on February 7, 2017, the account was sent to collections.  Once payment is made, it takes 5 to 6 business days for the payment to be posted into our billing system.  And as soon as the payment is posted, the account will be recalled from collections.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.
Sincerely,
[redacted]