Cheyenne Eye Clinic

August 10, 2017 Revdex.comSCounty Rd 5, Ste Fort Collins, CO 80528 Dear Mr***: I received documentation of complaint *** todayThe letter indicated that you had attempted to contact us prior but received no responseCan you please let me know if
you sent the first request via email or mail and to what address? In response to the complaint, Mr***.was referred to DrP*** by Dr*** *** from *** *** *** in LaramieWe saw Mr*** on 2/9/and again on 3/16/On March at 4:p.m, we spoke with *** from *** (***), Mr***'s insurer'We told *** that Mr*** was being seen for a diagnosis of Type II Diabetes and requested authorization for the injection (67028) and medication (J2778)*** told us that Mr***s's plan did not require prior authorization and we were to send chart notes with the claims. When Mr*** returned for his third visit on 4/25/he requested clarification on his previous billing and an assurance that that day's visit would be coveredAs we were unable to guarantee that Mr***'s visit would be paid in full, he left prior to being seen. A summary of events/charges is below: On 2/9/17, Mr*** was billed for an exam, an intraocular injection, a drug, an OCT and a Fluorescein ArigiographyThis claim was paid, with the exception of the drug, on 2/23/On 4/26/a reconsideration form was filed with *** with chart notes attachedThe reconsideration process can take up to daysOn 5/18/17, UCH corrected this claim and allowed the drug*** allowed $and showed this amount as the patient's responsibility as part of his deductible. For the 3/16/DOS, Mr*** was billed for two intraocular injections (right eye and left eye), drugs for each injection, and an OCTOn 3/30/17, *** paid for the OCT test and the injection fee for one eyeUpon investigation, it was determined that the original claim had inadvertently been filed with only one of two injection feesThis error was corrected and the claim refiled on 4/26/0n 5/18/17, *** reprocessed this claim and allowed the drugs; $was determined to be deductible, and $co-insuranceThe second eye injection was deniedOur standard process when filing a reconsideration with *** is to follin daysThis follow up was done on 8/10/Per ***; they had the claim but no chart notesChart notes were again faxed to ***This claim is still outstanding for the remaining injection feeUnfortunately, this process could take up to days from the date we faxed records, 8/10/17. The charges for both dates of service accurately reflect the services renderedWe are continuing efforts to receive correct payment from Mr***'s insurance carrier, *** At this time, we do not feel we should adjust these charges*** is still processing the remaining injection feeThe remaining balance is the patient's responsibility for deductible and co-insurance as per his insurance contract. Please feel free to contact me with any further questions. Thank you, Stacey O***Clinic Manager