Cedar Crest Emergicenter

July 20, Dear [redacted] ***, I read [redacted] ' letter carefullyIn it, she very clearly described the confusion that she encountered when she brought her daughter to Cedar Crest EmergiCenter for medical care and received a bill due to denial of the claim by her insurance company ***.Cedar Crest EmergiCenter is a Certified Urgent Care Facility as is Airport Road EmergiCenterBoth are certified as such by the Urgent Care Association of AmericaConfusion for the patient arises when individual insurance companies set their own criteria for determining a facility’s designation as urgent careOur facility is currently working with [redacted] to resolve a problem that is not related to quality of medical care but to the manner that our facilities are credentialed with ***Our facility billed appropriately for the service providedThe Website is correct in stating that both facilities are urgent care centersThe confusion lies in the fact that the patient’s insurance company is able to make their own determination of urgent care status and pay claims accordingly [redacted] ’ complaint is legitimate and clearly describes the problem that we are trying to resolve with ***After many attempts to appeal to the insurance company by describing the dilemma that this urgent care designation presents to the patient, we will continue to work with them to achieve resolution [redacted] ' letter will serve as a perfect example of the problemCedar Crest EmergiCenter will accept [redacted] ’ co-pay as payment in fullThis is the right thing to do because she was guided by accurate information on our Website that unintentionally resulted in denial of her claimSincerely, Joanne D

July 20, 2015Dear [redacted] ***,I read [redacted] ' letter carefullyIn it, she very clearly described the confusion that she encountered when she brought her daughter to Cedar Crest EmergiCenter for medical care and received a bill due to denial of the claim by her insurance company ***.Cedar Crest EmergiCenter is a Certified Urgent Care Facility as is Airport Road EmergiCenterBoth are certified as such by the Urgent Care Association of AmericaConfusion for the patient arises when individual insurance companies set their own criteria for determining a facility’s designation as urgent careOur facility is currently working with [redacted] to resolve a problem that is not related to quality of medical care but to the manner that our facilities are credentialed with ***.Our facility billed appropriately for the service providedThe Website is correct in stating that both facilities are urgent care centersThe confusion lies in the fact that the patient’s insurance company is able to make their own determination of urgent care status and pay claims accordingly[redacted] ’ complaint is legitimate and clearly describes the problem that we are trying to resolve with ***After many attempts to appeal to the insurance company by describing the dilemma that this urgent care designation presents to the patient, we will continue to work with them to achieve resolution [redacted] ' letter will serve as a perfect example of the problem.Cedar Crest EmergiCenter will accept [redacted] ’ co-pay as payment in fullThis is the right thing to do because she was guided by accurate information on our Website that unintentionally resulted in denial of her claim.Sincerely,Joanne D

July 20, 2015
Dear [redacted],
I read [redacted]' letter carefully. In it, she very clearly described the confusion that she encountered when she brought her daughter to Cedar Crest EmergiCenter for medical care and received a bill due to denial of the claim by her insurance...

company [redacted].Cedar Crest EmergiCenter is a Certified Urgent Care Facility as is Airport Road EmergiCenter. Both are certified as such by the Urgent Care Association of America. Confusion for the patient arises when individual insurance companies set their own criteria for determining a facility’s designation as urgent care. Our facility is currently working with [redacted] to resolve a problem that is not related to quality of medical care but to the manner that our facilities are credentialed with [redacted].
Our facility billed appropriately for the service provided. The Website is correct in stating that both facilities are urgent care centers. The confusion lies in the fact that the patient’s insurance company is able to make their own determination of urgent care status and pay claims accordingly.
[redacted]’ complaint is legitimate and clearly describes the problem that we are trying to resolve with [redacted]. After many attempts to appeal to the insurance company by describing the dilemma that this urgent care designation presents to the patient, we will continue to work with them to achieve resolution. [redacted]' letter will serve as a perfect example of the problem.
Cedar Crest EmergiCenter will accept [redacted]’ co-pay as payment in full. This is the right thing to do because she was guided by accurate information on our Website that unintentionally resulted in denial of her claim.
Sincerely,
Joanne D

July 20, 2015Dear [redacted],I read [redacted]' letter carefully. In it, she very clearly described the confusion that she encountered when she brought her daughter to Cedar Crest EmergiCenter for medical care and received a bill due to denial of the claim by her insurance company [redacted].Cedar...

Crest EmergiCenter is a Certified Urgent Care Facility as is Airport Road EmergiCenter. Both are certified as such by the Urgent Care Association of America. Confusion for the patient arises when individual insurance companies set their own criteria for determining a facility’s designation as urgent care. Our facility is currently working with [redacted] to resolve a problem that is not related to quality of medical care but to the manner that our facilities are credentialed with [redacted].Our facility billed appropriately for the service provided. The Website is correct in stating that both facilities are urgent care centers. The confusion lies in the fact that the patient’s insurance company is able to make their own determination of urgent care status and pay claims accordingly.[redacted]’ complaint is legitimate and clearly describes the problem that we are trying to resolve with [redacted]. After many attempts to appeal to the insurance company by describing the dilemma that this urgent care designation presents to the patient, we will continue to work with them to achieve resolution. [redacted]' letter will serve as a perfect example of the problem.Cedar Crest EmergiCenter will accept [redacted]’ co-pay as payment in full. This is the right thing to do because she was guided by accurate information on our Website that unintentionally resulted in denial of her claim.Sincerely,Joanne D

Review: Date of service 6/16/2006. I received treatment at the center and was charged and paid a co payment of $25.00 as indicated on my insurance card. Two years (July 2008) later I received a statement from the emergicenter claiming I owed a balance of $50.00. I called and talked to the billing department and was told my insurance company never paid the claim. I contacted my insurance company and was told they didn't have a claim for that date. I was told the emergicenter could submit the claim, that it would"go into review " due to the amount of time that elapsed. The insurance company denied the claim. After repeated phone calls, made by my wife and myself, back and forth to the emergicenters billing and my insurance company over the past 5 years we could not rectify this claim. We both, my wife and I, told them we didn't feel responsible for this balance. We paid our portion and with our insurance information they were to submit the claim for the balance in a time frame in which my insurance company allows. My wife made one last attempt to them to call and talk to our insurance company directly, providing a name/phone number, so THEY could figure this out-they refused. In June I received a collections notice in the mail for $67.50. My wife called the collections agency immediately and we are currently disputing the charge. Through the collection agency I offered to pay 50% of the bill as a resolution and an end to this madness and as a compromise. The offer was submitted by collections to the emergicenter and rejected by them on 6/28/13. * My whole family has been to this center for treatment, my wife, my children. Why couldn't someone there mention to one of us there was an insurance claim pending in a time frame in which we could have rectified with our insurance company, instead of waiting 2 years!Desired Settlement: I would like them to remove the monetary charges. Plus fees or additional fees from the collection agency.

Business

Response:

July 26, 2013

Revdex.com

RE: Revdex.com Complaint ID: [redacted]

This comes in response to a customer complaint that was sent to you by [redacted]. This response comes after I reviewed **. [redacted]'s complaint as well as the billing history that was compiled by our billing department from 2008 through 2013.

Based on our records, Cedar Crest EmergiCenter sent the bill for service provided on 6/16/2006 to [redacted] on 8/25/2006. This is well within timely filing limits. We fulfilled our obligation to submit the claim to the insurance company that the patient reported to us at time of service. We are not responsible for the lack of response or denial for payment of the claim by the insurance carrier. **. [redacted] reported in his letter that the claim was denied. We have no record of receiving this denial. The account was transferred to a collection agency.

On 7/28/2008, when the patient's wife called to inquire about the outstanding balance, our billing department assisted her by faxing a copy of the bill to IBEW. We did not get payment for the claim in response to the fax we sent. Therefore, the outstanding balance remained the responsibility of the patient. On March 23, 2009, the patient provided a different address to send the bill to for payment. Our billing history indicates that the bill was mailed to that address, Again there was no payment made on the claim by the insurance company.

On 1/13/2011, **. [redacted]'s wife called and gave us yet another address to mail the claim to for payment. We mailed the claim and got no response from the insurance company. On 12/23/2010, **. [redacted] contacted our office and stated that he paid his co-pay at the time of the service in 2006 and gave us insurance information. He indicated to the billing representative that he had met his responsibility and in his mind he was not obligated to pay the unpaid balance. He asked to have the unpaid amount written off. His request was denied.

To date, the claim has not been paid. It appears that the patient does not understand that he pays his insurance company. He has a contractual agreement with his insurance company. If that company does not pay his claims it is his responsibility to contact the insurance company and resolve the problem with them. Cedar Crest EmergiCenter assisted the patient to get the claim paid by re-submitting the claim several times and to total of three different addresses

Consumer

Response:

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

Review: [redacted]

I am rejecting this response because: They have not proven they billed my insurance company on 8/25/06. I have a statement sent from Cedar Crest emergicenter- the first attempt in billing was dated 07/01/08. The collection agency sent me a copy of this statement-first attempt in billing 07/01/08. When I received this statement more than two years after the date of service I called my insurance company. They had no claims from Cedar Crest emergicenter for that date of service. Cedar Crest emergicenter failed to file this claim in a time frame they know in which they are allowed payment by my insurance company. That is on them, I'm sorry. I tried to negotiate with them for 50% of the amount due through the collections agency to end this 5 year ongoing battle with them and they rejected the offer. I feel like this facility is playing games and I feel like I'm being harassed over $50.00 which was due to the billing error on their part from the start.