Center for Asthma and Allergy

.The nasal endoscopy was done on the initial visit and it is done as part of the patients diagnostic work up when necessaryIt was not billed out separately, it was all on our same claim and was assigned the same claim number by the insurance carrierWe cannot control how the insurance
company labels the procedureOur position is clear that it is a diagnostic test and not a surgical procedureIn this particular case the patient had a separate deductible that applied to this procedure (only) which our office was not aware of nor did we discuss with patient and because of that error the Doctor agreed to waive the charge. We extended the courtesy to her immediately after confirming with the carrier that this was in fact the case

.The nasal endoscopy was done on the initial visit and it is done as part of the patients diagnostic work up when necessaryIt was not billed out separately, it was all on our same claim and was assigned the same claim number by the insurance carrierWe cannot control how the insurance
company labels the procedureOur position is clear that it is a diagnostic test and not a surgical procedureIn this particular case the patient had a separate deductible that applied to this procedure (only) which our office was not aware of nor did we discuss with patient and because of that error the Doctor agreed to waive the charge. We extended the courtesy to her immediately after confirming with the carrier that this was in fact the case

I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to meMy only concern was that this was happening to other patients, and that they were paying incorrect amounts to either the insurance company or medical providerI know many people would rather pay their bill rather than dispute the charge, and it puts the insurance company and medical provider at an unfair advantage

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. My only concern was that this was happening to other patients, and that they were paying incorrect amounts to either the insurance company or medical provider. I know many people would rather pay their bill rather than dispute the charge, and it puts the insurance company and medical provider at an unfair advantage.

Review: I went to see the doctor (Parikh) about severe allergies. On one particular visit (I believe the first initial visit/consult) he performed a nasal endoscopy. Prior to performing this, I was not told it would be billed separately from my visit as a surgery. I was not told it was not part of the standard visit, covered by my insurance, and was not given the opportunity to withhold my consent to the procedure. I was under the impression it was standard and required. This procedure is not a surgery, and when I spoke to a woman at billing she assured me that they do not perform surgies. Yet, they billed my insurance as such and I received a bill in the mail to cover what my insurance did not. I contacted the office to explain the issue and to dispute the bill, and the bill was cleared off of my account. I am unsure how many times they have done this to other patients who are unaware of their own insurance plans. They could be making significant amounts of money from unassuming patients, and insurance companies, by fraudulently billing their patients' insurance companies.Desired Settlement: Just to investigate the issue to determine whether it was a clerical error or if there is actual insurance fraud occurring.

Business

Response:

.The nasal endoscopy was done on the initial visit and it is done as part of the patients diagnostic work up when necessary. It was not billed out separately, it was all on our same claim and was assigned the same claim number by the insurance carrier. We cannot control how the insurance company labels the procedure. Our position is clear that it is a diagnostic test and not a surgical procedure. In this particular case the patient had a separate deductible that applied to this procedure (only) which our office was not aware of nor did we discuss with patient and because of that error the Doctor agreed to waive the charge. We extended the courtesy to her immediately after confirming with the carrier that this was in fact the case.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. My only concern was that this was happening to other patients, and that they were paying incorrect amounts to either the insurance company or medical provider. I know many people would rather pay their bill rather than dispute the charge, and it puts the insurance company and medical provider at an unfair advantage.